A terminally ill teenager from Belgium has become the first minor to die with medical assistance from doctors.

The 17-year-old was not identified and very little details about the case have been released. However, Wim Distelmans, chair of Belgium's Federal Control and Evaluation Committee on Euthanasia, said the teenager was "suffering unbearable physical pain," the BBC reports.

"It's terrible when a youngster suffers, but it gives me some comfort to know that now there is a choice out there for children in the final terminal stages," said senator Jean-Jacques De Gucht, the Associated Press reports. "It's important that society doesn't neglect people in such pain."

Belgium passed a law in 2002 that gave terminally ill patients the “right to die” through euthanasia. In 2014, the law was extended to give minors assistance in dying. Throughout all cases, the law is extremely strict for assisted suicide to go ahead.

For minors, even tighter rules apply. It requires their full consent, parental consent, and the approval of two doctors, one of which is a psychiatrist. They must also be in the final stages of a terminal illness, fully conscious, able to make rational decisions and assert a wish to end their life on multiple separate occasions.

The number of reported assisted suicides in Belgium has risen year on year since legalization, according to a recent report by the Canadian Medical Association Journal. In 2002, there were 235 cases and by 2013 (the latest statistics) there were 1,807 cases.

Euthanasia is also legal – or effectively legal – in the Netherlands, Luxembourg, Canada, Switzerland, and the US states of Washington, Oregon, Vermont, California, and Montana. Although the law varies by country, some laws do not explicitly allow assisted suicide, but rather protect physicians who provide assisted suicide from liability. In Switzerland, for example, assisted suicide is essentially not legal, but it remains unpunishable unless “a selfish motive” is proven.

Many countries legally differentiate between “voluntary” and “nonvoluntary” euthanasia. Nonvoluntary includes cases where the patient is unable to give consent, for example, if they are brain-dead or in a coma. In “voluntary” cases, the patient is often required to administer the lethal drug themselves.

Much of the law remains blurry in many countries. For minors, where consent is not always obvious, it becomes even more thorny. Even outside of consent-related issues, the debate is surrounded by many ethical, legal, and medical concerns. 

Nevertheless, despite many opposing assisted suicide on religious or ethical grounds, the world’s ever-ageing population is likely to force this issue to the front of many debates over the coming decades.