A Biological Principle-Based Causal Framework for Clinical Reasoning

Abductive clinical reasoning requires explicit causal‑logical frameworks. Current major clinical‑reasoning theories primarily describe cognitive workflows but lack formal causal logical architecture, which renders clinicians vulnerable to spurious causal inferences. To address this gap, this article proposes the Objective Causal Logic of the Human Body (OCLHB), grounded in the core biological principle that structure determines function. Treated as a purpose‑oriented scientific model, OCLHB gains its rationality through representational fit for clinical cognitive tasks. Epistemologically, it is anchored in modern medical Ontology, holding that disease is rooted in biological structural substrates. Methodologically, it orients clinical inference toward observable biological entities and formalizes causal reasoning via four causal criteria: temporality, counterfactual dependence, mechanistic mediation and manipulability. Its core causal sequence follows “abnormal structure → abnormal function → diseased status (clinical manifestations)”. As a metacognition‑compatible reasoning model, OCLHB complements mainstream clinical‑reasoning theories. This work remains theoretical and awaits empirical validation. Even so, OCLHB supplies the missing formal causal architecture for clinical abduction. It carries intrinsic theoretical value, with meaningful potential to reform clinical education by offering biologically grounded, traceable reasoning scaffolds, as well as to mitigate diagnostic errors and inappropriate clinical interventions.