You pick the cause and then the game tells you the effect.
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In 4E you look at your powers and pick an effect. You use Come And Get It on a skeleton, it moves. You use Come And Get It on a guard, he moves. You use Come And Get It on an ooze, it moves. The EFFECT is established. You look at a list of potential EFFECTS and then you go back and think of narrative justification.
In 4E you pick and effect and then think of a cause.
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In pre-4E you pick a cause and the rules tell you the effect.
Your characterisation of 4e is, in my view, not entirely accurate. As I've posted numerous times in other threads, 4e's keywords matter here. They make an important mechanical contribution to fictional positioning in 4e. (For example, the reason that Fireball but not Icy Terrain can set a building on fire is that one, but not the other has the [Fire] keyword. Mutatis mutandis for freezing a stream so that you can walk across it.)
Your characterisation of pre-4e is, in my view, also not entirely accurate. In pre-3E D&D, saving throws generate an effect for which a cause within the fiction must then be posited (Gygax, in his DMG, gives the example of a fighter chained to a rock surviving a dragon's breath because at the last minute he found a niche in the rock, or the chains broke).
And in both classic D&D and 3E, the ingame character of hit point loss cannot be narrated until after the effect (in particular - was it fatal or not?) is known. (And given that a high-level fighter might survive that dragon's breath even with a failed save, presumably hit point narration can go beyond ducking and grazing to finding niches in rockfaces or breaking chains.)
That is not to deny that there are differences. For example, 4e follows 3E - and thereby departs from classic D&D - in its treatment of Fort, Ref and Will saves (renamed defences). And 4e departs from 3E and classic D&D in taking the fortune-in-the-middle style of hit points and saving throws and making them part of the "active" as well as the "passive" side of action resolution (so players can spend metagame resources not only to have their PCs survive the actions of others, but to have their PCs perform actions against those others).
Now, in 3E you CAN make someone trip into a hole. But you must have some source of effect to make that happen. I certainly agree that you can't cause someone to stumble into a hole in a manner that wasn't caused by the character. I think that is a great positive thing.
I personally don't see why the absence of metagame mechanics on the "active" side is so great, but its presence on the "passive side" (via hit points) is untroubling.
To put it more bluntly: as I've noted in the past, given your apparent preferences I don't really understand why you're not playing either Runequest, or (if you think the absence of metagame plot protection for PCs would be too gritty) HARP. In HARP, Fate Points can be spent either "actively" or "passively", but in virtue of being a Fate Point mechanic rather than a more "embedded" mechanic like hit points, classic D&D saves, or (some) 4e martial powers, it makes the fiction/metagame distinction crystal clear.