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It's been a wild few weeks for documentary films. (How often do we get to say that?) On March 17, SeaWorld announced it would end its orca breeding programs and live shows, in part because of the outcry raised by the 2013 documentary Blackfish.

Then last Monday, New York's Tribeca Film Festival (TFF) kicked a hornet's nest by announcing it would show the documentary Vaxxed: From Cover-Up to Catastrophe, directed by Andrew Wakefield, a former gastroenterologist who published a 1998 study linking measles-mumps-rubella vaccines to autism.

The Internet erupted in protest. Not only has Wakefield's study been widely discredited and disproved, he was stripped of his medical licence and is reviled by the medical community: They hold him responsible for the drop in vaccinations, which has led to the re-emergence of nearly eradicated diseases, such as whooping cough and measles.

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Last Friday, TFF founder Robert De Niro issued a statement saying that he personally put Vaxxed on the schedule to spark debate, because he and his wife, Grace Hightower, have a child with autism. The next day, however, he issued a reversal: "After reviewing it over the past few days with the Tribeca Film Festival team and others from the scientific community … we have concerns with certain things in this film … We have decided to remove it from our schedule."

It didn't end there, though. On Tuesday, Variety reported that Cinema Libre Studio, whose website bills it as "a leader in the production and distribution of … social-issue non-fiction films," announced that it will distribute Vaxxed, beginning this Friday at the Angelika Film Center in New York – mere blocks from the TFF events.

With Toronto's Hot Docs festival a month away, all this has me wondering: How much truth should we expect from a documentary? Is a doc always, ipso facto, "non-fiction?" Who's responsible for vetting docs – the filmmakers, the festivals that program them, the entities that distribute them, or the audiences who consume them?

Of course, documentaries always have been constructed. One of the first, Nanook of the North (1922), featured recreated scenes and an igloo built with a hole in it so the camera could get inside. Interviews are edited; choreographed events are seen as "real;" select facts are presented as "truths" – all to create narratives.

In recent decades, however, we've seen a tremendous rise in documentaries that not only admit, but flaunt, that they're constructions. First-person, point-of-view docs have skyrocketed, such as Super Size Me and Michael Moore's films, where we're invited to share in (and believe) a packaged, subjective version of the filmmaker's experience, which is as much about expression and emotion as it is reporting.

We've seen an equally dramatic rise in so-called impact docs, whose goal is to advocate passionately enough for a cause that the audience is whipped into action. (Blackfish, An Inconvenient Truth and Vaxxed belong to this category.) We're going to see a lot more of them: Recognizing how rapidly issues spread in our social-media age, designated funding bodies and unique promotional opportunities have sprung up for impact docs – all you need is a camera and a cause.

To make matters murkier, the newest trend in docs is "creative non-fiction" – documentaries that incorporate elements of fiction, in order to get at larger truths. Hot Docs will be showing several.

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In All These Sleepless Nights (which also played at this year's Sundance Film Festival), art students roam Warsaw, experiencing events that the filmmakers set up to see how they respond to them. Like an art-house version of reality TV, it manipulates its subjects in order to explore big questions (who am I, what is love, what do I want from life?).

Where Is Rocky II? is constructed like a hard-boiled Hollywood noir, as its two screenwriters, playing themselves, search for an enigmatic artwork. And in Love True, director Alma Har'el uses younger and older actors to portray past and future versions of her subjects, to examine the notion of lasting love.

"A new wave of emerging filmmakers is interested in expanding the vocabulary and conversation about what documentary is," says Shane Smith, Hot Docs's director of programming. "They want to push the form, experiment with its parameters and boundaries."

Again, fictional elements are not new to documentaries: Errol Morris used recreations in The Thin Blue Line (1988), and Sarah Polley had actors portray her family in Stories We Tell (2012). But they're being deployed more and more assertively to draw attention to the idea that documentary is a mediated experience. In that way, modern filmmakers argue, they're actually more honest about how they pursue their truths.

"The Thin Blue Line is one of my favourite documentaries," Smith says. "Its re-creations were the subject of much debate when it came out. Yet, it had tremendous real-world impact: getting a man freed from prison. Just because there were fictional elements didn't mean the evidence couldn't be considered."

Here's the thing, though: As the release of Vaxxed proves, we live in a time where anyone can find a platform for any quackery they want to put forth. People already pick and choose which facts they want to believe in news stories – how am I supposed to trust a doc?

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For his part, Smith and his programmers look for "interesting stories, well told, that are sound, that stand up to critical review, and that don't propagate erroneous perspectives," he says. Before making programming decisions, they frequently Google subjects and filmmakers to find out more detail about submitted work; they'll also interview filmmakers about their methods and intentions.

"We never set out to fool the audience," Smith says. Hot Docs mentions fictional elements in its program notes, or has the filmmakers raise them live in post-screening discussions.

Are we asking a lot of audiences to navigate such nuanced questions (unreal versus untrue) – or are moviegoers now sophisticated and media-literate enough that it's not an issue? "I don't want to spoon-feed an audience," Smith replies. "Hot Docs is part of the conversation on what documentary is and where it's heading."

A few years ago, the festival screened a film that claimed to have discovered Bigfoot. Most viewers understood that it was really a look at the people who believe in the myth. But some Bigfoot conspiracists did show up, wanting to know where the footage came from.

This year, the documentary Fraud is similarly head-swirling. A real family uploaded to the Internet hundreds of hours of their home movies. A filmmaker found it, got their permission to use it, and then reconstructed it into a new narrative, which examines the pursuit of happiness via rampant consumerism. So the footage is real, and their lives are real, but the documentary is … fake? A construction? A larger truth gleaned from a lie? You tell me.

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