Abstract: Forensic clinical appraisal serves as a crucial link between medical facts and judicial judgments. Its core mission is to precisely define the causal relationship between the injurious act and harmful outcomes from a medical perspective. In judicial practice, the objective reconstruction of factual causation and the normative judgment of legal causation are invariably intertwined. The application of the legal concept of causative potency in the field of forensic appraisal further highlights the deep integration of technical judgment and legal thinking. Factual causality and legal causality differ essentially in the judging subject, criteria, and objectives. In scenarios such as single causality and multiple-cause-single-effect causality, practitioners confront difficulties in distinction, including the conflict between technical boundaries and legal demands, and the cross-border application of causal potency.This paper systematically reviews the theoretical differences between factual causation and legal causation, analyzes their specific manifestations in forensic clinical appraisal, and focuses on the evolutionary trajectory and practical challenges of the distinction pathway. According to the current application status of causative potency assessment, it proposes a balancing strategy between technical rationality and legal thinking in appraisal, providing theoretical support and practical reference for enhancing the scientific robustness and legal applicability of forensic clinical appraisal opinions.

Key words: forensic clinical appraisal, factual causation, legal causation, causative potency, distinction pathway

摘要： 法医临床鉴定作为衔接医学事实与司法裁判的关键纽带，其核心使命在于从医学视角精准界定损害行为与损害结果之间的因果联系。在司法实践中，事实因果关系的客观还原与法律因果关系的规范判断始终处于交织状态，而原因力这一法律概念在鉴定领域的应用，更凸显了技术判断与法律思维的深度融合。事实因果关系与法律因果关系在判断主体、标准与目标上存在本质差异。而在单一因果、多因一果等场景中，实践中面临技术边界与法律需求冲突、原因力跨界适用等区分难点。本文系统梳理事实因果关系与法律因果关系的理论分野，剖析二者在法医临床鉴定中的具体呈现形态，重点探讨区分路径的演进脉络与实践困境，结合原因力评定的应用现状，提出鉴定中技术理性与法律思维的平衡策略，为提升法医临床鉴定意见的科学性与法律适用性提供理论支撑与实践参考。

关键词: 法医临床鉴定, 事实因果关系, 法律因果关系, 原因力, 区分路径