Palliative practice in Indian health.

Palliative care and end-of-life services are poorly available yet critically needed among AI/AN people. Anumber of formal programs are in place that can serve asmodels for future programs. Formal training in palliative care for IHS providers was started in 2001 and continues on annual basis. The involvement of groups such as the NCI should help propel these efforts forward more quickly. It is essential that all of these efforts bring services that are both culturally relevant and sensitive to people who often face desperate situations with limited resources, options and hope. To paraphrase Robert Frost, the journey has started but we have miles to go before we sleep.