There is no “and” in Cause-and-Effect.  Cause and Effect are one and the same uninterrupted flow of reality.  Mind breaks up the flow of this reality into Cause and Effect b/c of its information-processing limitations, essentially, dropping out of the flow of “What Is” to deal with reality (by categorizing it, by breaking it up into moments and ideas).  So, when you choose a Cause, you choose an Effect.  That’s Karma: karma is not fate, karma is self-determinism.  Karma, as a form of voluntary self-determinism bridges the classic dichotomy of free will and determinism.  In my interpretation, karma (as a psychological term) is a free act of self-determination.