Differences in psychiatrist training as well as the civil culture and health insurance system of each country may have contributed to the differences in these rates. The concept of drug loading can be applied to other medical fields.

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Derived from the Indian Criminal Procedure Code, Sri Lanka's Criminal Procedure Code which provides for 'fitness to plead' criteria in the country is unchanged from when it was introduced in the nineteenth century. As it lacks clear definitions, does not provide specific instructions for the disposal of mentally unwell offenders and operates in isolation from other related laws, the case for its review is both strong and urgent.

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