Wellspring raises a series of issues about the ethical responsibilities of documentary filmmakers, about childhood and the healthcare system. First, the film itself implicitly draws attention to the contrast between the independent documentary scene and mainstream television in a scene where the father contacts a friend who he thinks might be able to help them get onto a television show, in the hope that publicising their case might lead to financial assistance. But this does not seem to lead anywhere, contrasting the mainstream media to the more sustained interest of the filmmakers. However, are the filmmakers really assisting Xiguan? Having chosen to follow the “fly on the wall” observational style favoured by the independent documentary movement in China, they risk being accused of not even helping in the most basic ways. For example, when Xiguan is alone in his home-made wheelchair in the farmhouse yard, and leaning so far back that he is almost falling out, they simply film his helplessness and do not assist him.

For those who believe in this mode of filmmaking, the filmmakers must stand back from what is happening in front of the camera in order to guarantee the veracity of what the audience is seeing. Only by treating their subject with apparent indifference can we be made to understand fully how hard the boy’s situation is and how helpless he is. But, of course, that does not help the subject directly –at most, only indirectly, if publicising his or her plight helps to inspire future assistance to others in the same situation.

The difficulty of watching the filmmakers not step in to help when it might appear natural to do so also raises a set of larger questions about the responsibility not only of Xiguan’s grandfather, who does not sell his two cows to help pay for his grandchild’s medical care even though he has promised to do so, but also of those unrelated to the family, including the film’s audience. Do we have less of a responsibility to help, just because we are not related? And are there different understandings of moral responsibility at work here? For example, the Christian idea of the so-called “good Samaritan” and related ideas of “charity”? Or the Buddhist idea of “karma” and storing up credit for the future? Or the Confucian idea of ren(仁), sometimes translated as altruism? How do these ideas play out in this situation?

Next, there is the question of consent and how it is understood. The family are desperate, and, as the scene where they try to contact the television station shows, they have thought about the potential benefits of publicity. But to what extent can an impoverished family faced with a dying child be said to have given consent to the making and screening of this film? Furthermore, can Xiguan himself be said to have given consent? This is a particularly difficult issue, for a number of reasons. First, we have to rely on his family members’ interpretations of his leg movements to understand what they think he thinks. Second, as a minor, does Xiguan have the capacity and, if so, a right to determine his own future and what happens to him?

Related to questions of childhood are questions of privacy. The camera invades the family home and invites us to stare at Xiguan, just as passersby gather round and stare when his father takes him into town. If we feel the passersby are inconsiderate, what does that make us? To what extent is this a general issue, and to what extent does it bring up cultural differences around privacy? It is commonplace to make generalisations that Western culture is obsessed with privacy, whereas Chinese culture has little or no sense of privacy. But this is too simple. For example, I think it would not be impossible to interview Western subjects about their sex lives, but it might be quite difficult to get Chinese people to talk about sex on camera. There are different ideas of what is and is not private, and this must have implications for what is considered a sensitive way to handle someone’s illness.

Xiguan’s refusal of food also raises the question of assisted dying versus the sanctity of life. Is the father’s desire to continue with treatment when all appears to be hopeless a sign of his commitment to his son? Or is it a selfish desire to continue to have a son, no matter how much the boy is suffering? The debates about the sanctity of life versus assisted dying are very live issues in Western countries at the moment. There are many opinions, inflected by different religious and moral beliefs, as well as ideas about the rights of the individual. Is there an active debate about such issues in China?

Wellspring further raises the issue of the right to medical care. What level of medical care and expenditure is appropriate for a dying child who, it seems, is beyond treatment? Who should pay for that care? Why should the child be condemned to suffer because of his parents’ poverty? The provision of medical care is a controversial issue worldwide. In the UK, the cost and efficacy of the National Health Service, which provides free medical care for all at the point of delivery, is frequently debated. In the US, “Obama Care” has been a hugely controversial issue in a country which, although rich, guarantees very little medical care to its citizens. What about China?

Finally, the film itself does not treat illness purely as a physical medical condition of a lone individual. Instead, as the Chinese title, 在一起的时光 (“Time Spent Together”) implies, it treats illness as a group experience. The illness affects the boy most profoundly, but it also affects everyone else in the family and their relationships with each other, as well as their ability to work and to support themselves and each other. The film shows clearly that caring for the boy involves mobilising a team of people with emotional commitments to him that transcend their individual material interests – in this case, his family. Therefore, the implication might be that medical professionals need to work together with social workers to look after the whole family if the boy is to receive appropriate care throughout the rest of his life, however long or short that may be.

Professor Chris BERRY (King's College London)