Contextual factors, a prominent example of which is Contextual diseases, are divided into two general categories, predisposing and causative, in terms of their role and effect on the occurrence of injury or harmful consequences. The first category includes factors that have an accelerating or aggravating role. In the second category, the function of the factors is to create results. Mainly, contextual factors appear in the first role. Therefore, often, the underlying conditions of the victim must not be considered cause. The research method in this article is descriptive and analytical, citing library resources, articles, and some criminal laws related to the subject, and utilizing some court decisions and expert opinions in medical malpractice cases. Findings show that although rarely, contextual factors have a creative role and appear as a cause; but in practice, courts make verdicts in cases of interference between contextual factors and the perpetrator's fault, especially in medical malpractice cases, based on expert comments and medical commissions. Determining the percentage of influence of contextual factors in expert opinions, which is reflected in judicial decisions, although a specialist approach may justify it, since the victim's illness and Contextual factors are not considered fault, attributing outcome to them is contrary to legal principles. Taking such an approach means considering the causal role of the disease and Contextual factors and subsequently reducing the responsibility of the perpetrator. Of course, the main challenge generally concerns unintentional crimes, especially medical malpractice cases.