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Life sciences · Preprint
arXiv · September 16, 2026
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Observational decision-support systems often expose one causal estimate as a recommendation even when plausible estimators disagree. The inherent engine of the proposed system is causal machine learning: a conditional-average-treatment-effect estimand identified by backdoor adjustment, estimated by an EconML DML causal forest and DoWhy linear regression, checked by two-way fixed effects, and converted into candidate levers by constrained optimisation. F-DACE is the decision layer on that engine. It represents precision, propensity overlap, placebo-refutation stability, interval overlap, and directional agreement as fuzzy memberships. Hard vetoes force abstention after estimand mismatch, failed diagnostics, informative sign conflict, or weak evidence. In 180 panel simulations spanning six identification conditions, F-DACE made a decision in 67.2% of runs and limited false recommendations to 17.2%; the corresponding rates were 33.3% for the causal forest and 35.6% for backdoor regression, matching deterministic unanimity rather than dominating it. Nearly all (30 of 31) false recommendations occurred under shared unmeasured confounding, which no fusion rule can diagnose when every component shares the omitted variable. The retail application aggregates a public Walmart panel to 6,435 store-weeks across 45 stores. F-DACE abstains for all five markdown indicators: some estimates are imprecise, one refutation fails, and MarkDown5 has a direct sign conflict. A LangGraph conversational agent exposes impact, what-if, and lever-optimization tools while a deterministic verifier preserves causal-layer status. On 24 live questions it achieved 100.0% tool-routing accuracy, 100.0% status fidelity, and 0.983 mean groundedness. On ten adversarial questions it resisted all injected instructions.