Hypokinesia is one of the classifications of movement disorders, and refers to decreased bodily movement. Hypokinesia is characterized by a partial or complete loss of muscle movement due to a disruption in the basal ganglia. Hypokinesia is a symptom of Parkinson's disease
shown as muscle rigidity and an inability to produce movement. It is
also associated with mental health disorders and prolonged inactivity
due to illness, amongst other diseases.
Slowness of initiation of voluntary movement with a progressive
reduction in speed and range of repetitive actions, such as voluntary
finger-tapping. It occurs in Parkinson's disease
and other disorders of the basal ganglia. It is one of the four key
symptoms of parkinsonism, which are bradykinesia, tremor, rigidity, and
postural instability.
A condition which affects the muscles necessary for speech, it
causes difficulty in speech production despite a continued cognitive
understanding of language. Often caused by Parkinson's disease, patients
experience weakness, paralysis, or lack of coordination in the
motor-speech system, causing respiration, phonation, prosody, and articulation
to be affected. Problems including tone, speed of communication, breath
control, volume, and timing are displayed. Hypokinetic dysarthria
particularly affects the volume of speech, prompting treatment with a speech language pathologist.
This is characterized by a diminished ability for voluntary
movements, as well as the presence of involuntary movements. The hands
and upper body are the areas most likely to be affected by tremors and
tics. In some cases, Parkinson's patients experience dyskinesia as a
negative side effect of dopamine medications.
Resulting from heavy exposure to drugs that block dopamine
receptors, victims can experience fever, rigidity, mental status change,
dysautonomia, tremors, dystonia, and myoclonus. While this disorder is extremely rare, immediate attention is necessary because of the high risk of death.
Rigidity
Resistance to externally imposed ("passive") joint movements, such as when a doctor flexes a patient's arm at the elbow joint.
It does not depend on imposed speed and can be elicited at very low
speeds of passive movement in both directions. Cogwheel rigidity and
leadpipe rigidity are two types identified with Parkinson's disease:
Leadpipe rigidity is sustained resistance to passive movement throughout the whole range of motion, with no fluctuations.
Cogwheel rigidity is jerky resistance to passive movement as muscles tense and relax.
Spasticity,
a special form of rigidity, is present only at the start of passive
movement. It is rate-dependent and only elicited upon a high-speed
movement. These various forms of rigidity can be seen in different forms
of movement disorders, such as Parkinson's disease.
A disturbance in balance that impairs the ability to maintain an
upright posture when standing and walking. In Parkinsons disease it is
correlated with greater disability and more depression, as well as with
frequency of falls and fear of falls (which, itself, can be
significantly disabling).
A person with medication-induced dystonia
Causes
The most common cause of Hypokinesia is Parkinson's disease, and conditions related to Parkinson's disease.
Other conditions may also cause slowness of movements. These include hypothyroidism and severe depression. These conditions need to be carefully ruled out, before a diagnosis of Parkinsonism is made.
The remainder of this article describes Hypokinesia associated
with Parkinson's disease, and conditions related to Parkinson's disease.
Pathophysiology
Associated neurotransmitters
Dopamine
The main neurotransmitter thought to be involved in hypokinesia is dopamine.
Essential to the basal ganglionic-thalamocortical loop, which processes
motor function, dopamine depletion is common in these areas of
hypokinesic patients. Bradykinesia is correlated with lateralized dopaminergic depletion in the substantia nigra.
The dopamine pathway in the substantia nigra is essential to motor
function, and commonly a lesion in this area correlates with displayed
hypokinesia. Tremor and rigidity, however, seem to be only partially due to dopamine
deficits in the substantia nigra, suggesting other processes are
involved in motor control.
Treatments for hypokinesia often either attempt to prevent dopamine
degradation by MAO-B or increase the amount of neurotransmitter present
in the system.
GABA and glutamate
The inhibitory neurotransmitter GABA and the excitatory glutamate are found in many parts of the central nervous system,
including in the motor pathways that involve hypokinesia. In one
pathway, glutamate in the substantia nigra excites the release of GABA
into the thalamus, which then inhibits the release of glutamate in the
cortex and thereby reduces motor activity. If too much glutamate is
initially in the substantia nigra, then through interaction with GABA in
the thalamus and glutamate in the cortex, movements will be reduced or
will not occur at all.
Another direct pathway from the basal ganglia sends GABA inhibitory messages to the globus pallidus
and substantia nigra, which then send GABA to the thalamus. In the
indirect pathway, the basal ganglia send GABA to the globus pallidus
which then sends it to the subthalamic nucleus, which then disinhibited
sends glutamate to the output structures of the basal ganglia.
Inhibition of GABA release could disrupt the feedback loop to the basal
ganglia and produce hypokinesic movements.
GABA and glutamate often interact with each other and with dopamine directly. In the basal ganglia, the nigrostriatal pathway is where GABA and dopamine are housed in the same neurons and released together.
Neurobiology
Hypokinetic
symptoms arise from damage to the basal ganglia, which plays a role in
producing force and computing the effort necessary to make a movement.
Two possible neural pathways enable the basal ganglia to produce
movement. When activated, the direct pathway sends sensory and motor
information from the cerebral cortex to the first structure of the basal ganglia, the putamen.
That information directly inhibits the globus pallidus internal and
allows free movement. The indirect pathway, traveling through the
putamen, globus pallidus external, and subthalamic nucleus, activates
the globus pallidus internal threshold and inhibits the thalamus from communicating with the motor cortex, producing hypokinetic symptoms.
Basal ganglia (red) and related structures (blue)
When levels of dopamine decrease, the normal wave-firing pattern of basal ganglia neural oscillations changes and the tendency for oscillations increases, particularly in the beta wave of the basal ganglia.
Recent research indicates, when oscillations fire simultaneously,
processing is disrupted at the thalamus and cortex, affecting activities
such as motor planning and sequence learning, as well as causing hypokinetic tremors.
Treatments
Dopaminergic drugs
Dopaminergic drugs are commonly used in the early stages of the hypokinesia to treat patients. With increased intake, though, they can become ineffective because of the development of noradrenergic lesions.
While initially the dopaminergic drugs may be effective, these
noradrenergic lesions are associated with hypokinesic gait disorder
development later on.
Some Parkinson's patients are unable to move during sleep,
prompting the diagnosis of "nocturnal hypokinesia". Physicians have
experienced success treating this sleep disorder with slow-release or
night-time dopaminergic drugs, and in some cases, continuous stimulation by the dopamine agonistrotigotine.
Despite improved mobility during sleep, many Parkinson's patients
report an extremely uncomfortable sleeping experience even after
dopaminergic treatments.
Deep brain stimulation
Once the reaction to dopaminergic drugs begins to fluctuate in Parkinson's patients, deep brain stimulation (DBS) of the subthalamic nucleus and internal globus pallidus is often used to treat hypokinesia. DBS, like dopaminergic drugs, initially provides relief, but chronic use causes worse hypokinesia and freezing of gait. Lower-frequency DBS in irregular patterns has been shown to be more effective and less detrimental in treatment.
Parkinson surgery
Posteroventral pallidotomy (PVP) is a specific kind of DBS that
destroys a small part of the globus pallidus by scarring the neural
tissue, reducing brain activity and therefore tremors and rigidity. PVP
is suspected to recalibrate basal ganglia activity in the
thalamocortical pathway. PVP in the dominant hemisphere has been
reported to disrupt executive function verbal processing abilities, and
bilateral PVP may disturb processes of focused attention.
Many akinesia patients also form a linguistic akinesia in which
their ability to produce verbal movements mirrors their physical
akinesia symptoms, especially after unsuccessful PVP.
Patients are usually able to maintain normal levels of fluency, but
often stop midsentence, unable to remember or produce a desired word. According to a study of Parkinson's patients with articulatory hypokinesia,
subjects with faster rates of speech experienced more problems trying
to produce conversational language than those who normally spoke at
slower rates.
Methylphenidate
Methylphenidate, commonly used to treat ADHD, has been used in conjunction with levodopa to treat hypokinesia in the short term. The two work together to increase dopamine levels in the striatum and prefrontal cortex.
Methylphenidate mainly inhibits dopamine and noradrenaline reuptake by
blocking presynaptic transporters, and levodopa increases the amount of
dopamine, generally improving hypokinesic gait.
Some patients, however, have adverse reactions of nausea and headache
to the treatment and the long-term effects of the drug treatment still
need to be assessed.
Stem cells
New
treatments include increasing the number of dopamine cells by
transplanting stem cells into the basal ganglia or stimulating
endogenous stem cell production and movement to the basal ganglia.
The successful integration of stem cells can relieve hypokinetic
symptoms and decrease the necessary dose of dopaminergic drugs. However,
a variety of complications, including possible tumor formation,
inappropriate cell migration, rejection of cells by the immune system,
and cerebral hemorrhage are possible, causing many physicians to believe the risks outweigh the possible benefits.
NOP receptor antagonists
Another treatment, still in an experimental stage, is the administration of nociception FQ peptide (NOP) receptor antagonists.
This treatment has been shown to reduce hypokinesia in animal studies
when increasing nociception FQ in the substantia nigra and subthalamic
nucleus. Low doses can be taken with dopaminergic treatment to decrease
the amount of L-dopa needed, which can reduce its long-term side effects and improve motor performance.
Dance therapy
Dance therapy
has also been shown to reduce hypokinesic movements and rigidity,
though targeted more at the muscular aspects of the disorder than the
neural activity.
Associations
Cognitive impairment
Bradykinesia has been shown to precede impairment of executive functions, working memory, and attention. These cognitive deficiencies can be tied to nonfunction of the basal ganglia and prefrontal cortex, which is also linked to the motor-dysfunction of hypokinesia.
Tremor and rigidity have not had observable connections to cognitive
impairments, supporting the idea that they are not as involved in the
dopamine pathway in the basal ganglionic-thalamocortical loop.
Dopaminergic treatments have shown improvement in cognitive functions
associated with hypokinesia, suggesting they are also dependent on
dopamine levels in the system.
Motor motivation
Often
debated is whether the efficiency, vigor, and speed of movements in
patients with hypokinesia are tied to motivation for rewarding and
against punishing stimuli. The basal ganglia have been tied to the
incentives behind movement, therefore suggesting a cost/benefit analysis
of planned movement could be affected in hypokinesia. Rewards have not
been shown to change the aspects of a hypokinesic individual's movement.
In fact, the motor planning and control of a patient with hypokinesia
is already as efficient as possible (as shown by slightly faster, but
generally the same movement after deep brain stimulation of the subthalamic nucleus).
This suggests that hypokinetic individuals simply have a narrower range
of movement that does not increase relative to motivation.
Other studies have come to the same conclusion about rewards and
hypokinesia, but have shown that aversive stimuli can, in fact, reduce
hypokinesic movement. Dopamine is either less involved or has a more
complex role in the response to punishment than it does to rewards, as
the hypodopaminergic striatum allows more movement in response to aversive stimuli.
Demographic differentiation
Gender
More men than women typically develop hypokinesia, which is
reflected in young and middle-aged populations where females have
displayed higher levels of nigrostriatal dopamine than males. In the
elderly, however, this differentiation is not present. Typically, women
exhibit more tremor in the beginning development of hypokinesia. In the
disorder, men tend to display more rigidity and women more bradykinesic
motor behavior.
Age of onset
Hypokinesia is displayed in the brain and outwardly slightly
different depending on when an individual is first affected. In
young-onset hypokinesia (younger than 45 years of age), typically
slightly more cell loss occurs in the substantia nigra with more
displayed dystonia
and muscle stiffness. In old-onset hypokinesia (older than 70 years of
age), typically more of a hypokinesic gait and difficulty walking and no
dystonia are seen. Both onsets can display resting tremor, although
more generally found in old-onset cases.
Symptoms
Stress causes alterations of cerebral circulation, increasing blood flow in the supramarginal gyrus and angular gyrus of the parietal lobe, the frontal lobe, and the superior temporal gyrus
of the left hemisphere. Also, an increase in cardiac activity and
change in the tonus of the heart vessels occurs, which is an elementary
indication of stress development. In patients with normal stress, an
adaptive fight-or-flight response is usually triggered by sympathetic nervous system
activation. Hypokinesia patients experience these typical stress
symptoms on a regular basis because of damage to the basal ganglia
system. Therefore, when a hypokinesia victim is under stress, he or she
does not display a typical fight-or-flight response, placing the patient
under greater danger from potentially harmful stimuli.
Low-impact exercise, elimination of drug and alcohol use, and regular
meditation can help to restore normal stress responses in hypokinesia
patients.
Connections to other medical conditions
Though it is often most associated with Parkinson's disease, hypokinesia can be present in a wide variety of other conditions.
Damage to certain areas of the brain due to lack of oxygenation has
been found to cause hypokinetic symptoms. Frontal and subcortical
lesions caused by stroke are more likely to cause hypokinesia than
posterior lesions.
Chronic hyperammonemia and liver disease
can alter neurotransmission of GABA and glutamate by increasing the
amount of glutamate in the substantia nigra and inhibiting movement.
Very similar to Parkinson's disease, supranuclear palsy does not
actually display the hypokinetic characteristic of progressive loss of
movement, despite small amplitude. Diagnosis of hypokinesia can help to
distinguish this disorder from Parkinson's.
Alcohol use in pregnancy includes use of alcohol at any time during gestation, including the time before a mother-to-be is aware that she is pregnant. Alcohol use at some point during pregnancy is common and appears to be rising in prevalence.
The variance seen in outcomes of alcohol consumption during
pregnancy is poorly understood, however genetic and social risk factors
for more severe outcomes have both been suggested. The effect of quantity and gestational timing of alcohol consumption is also poorly understood. However, there is no amount of alcohol that is known to be safe to drink while pregnant, and there is no safe time point or trimester of pregnancy during which alcohol consumption has been proven to be safe. Therefore, medical consensus is to recommend complete abstinence from alcohol during pregnancy.
Some evidence suggests that the likelihood of FASD, FAS,
miscarriage and stillbirth increases with higher quantity and longer
duration of alcohol consumption during pregnancy.
Therefore, it is never too late to reduce the likelihood of FASDs, FAS,
and alcohol related pregnancy complications by avoiding or limiting
alcohol use.
Embryology
Different
body systems in the infant grow, mature and develop at specific times
during gestation. The consumption of alcohol during one or more of these
developmental stages may only result in one or few conditions.
During the first weeks of pregnancy babies grow at a rapid pace,
even before the mothers know they are pregnant. From conception and to
the third week, the most susceptible systems and organs are the brain,
spinal cord, and heart. These crucial organs start forming in early
stages of pregnancy, which are very sensitive and critical periods in
human development. Though these body systems complete their development
later in the pregnancy, the effects of alcohol consumption early in the
pregnancy can result in defects to these systems and organs.
During the fourth week of gestation, the limbs are being formed and it
is at this point that alcohol can effect the development of arms, legs,
fingers and toes. The eyes and ears also form during the fourth week and
are more susceptible to the effects of alcohol.
By the sixth week of gestation, the teeth and palate are forming and
alcohol consumption at this time will affect these structures.
Alcohol use in this window is responsible for many of the facial
characteristics of fetal alcohol syndrome. By the 20th week of gestation
the formation of organs and organ systems is well-developed. The infant
is still susceptible to the damaging effects of alcohol. Therefore, it would be safer for women to stop drinking prior to trying to conceive.
The baby's brain, body, and organs are developing throughout
pregnancy and can be affected by exposure to alcohol at any time.
Because every pregnancy is different, drinking alcohol may hurt one baby
more than another. A child that has been affected by alcohol before
birth may appear 'normal' at birth. Intellectual disabilities may not
appear until the child begins school.
According to a study done by the University of Houston, through
the use of Speckle variance optical cohearance tomography (SVOCT), it
was discovered that 45 minutes after pregnant mice were exposed to a
binge like bolus of ethanol,
a dramatic decrease in the size and number of blood vessels in the
fetal brains of the mice was observed. Thus, demonstrating the magnitude
of potential damage caused by a single prenatal alcohol exposure.
Alcohol during pregnancy
The
developing fetus is exposed to the alcohol through the placenta and
umbilical cord. Alcohol metabolizes slowly in the fetus and remains for a
long time when compared to an adult because of re-uptake of
alcohol-containing amniotic fluid.
Alcohol exposure has serious implications on the developing fetus as
well as the mother. When a woman is planning for pregnancy, she should
keep in mind that there is no safe limit for alcohol consumption.
It can lead to premature birth and problems may manifest later as the
child continues to grow. One of the main problematic outcomes in the
developing baby is fetal alcohol syndrome
(FAS), which is characterized by: cleft palate and/or cleft lip,
disproportionate physical development of the body, and various
disabilities like attention deficiency, low memory and coordination
ability, as well as improper functioning of various body organs like the
kidneys, heart and bones. A large range of other developmental
abnormalities are also associated with alcohol consumption during
pregnancy, including an abnormal appearance, short height, low body
weight, small head size, poor coordination, low intelligence, behavioral
problems, hearing loss, and vision problems. These less severe outcomes are collectively termed Fetal alcohol spectrum disorders (FASDs).
Those affected are more likely to have trouble in school, legal
problems, participate in high-risk behaviors, and have trouble with
alcohol and recreational drug use. Spontaneous abortion, stillbirth, low birthweight, and prematurity are other common outcomes, along with increased likelihood of domestic violence and potential harm to the infant.
These effects can be magnified especially during the first and
third trimester of pregnancy when the baby is growing rapidly. Alcohol
consumption in the first trimester of pregnancy, which is a crucial
developmental stage of fetal growth, can have serious consequences.
The developing fetus can be exposed to alcohol in the earliest weeks of
pregnancy. During the third week, alcohol can affect the heart and
central nervous system of the fetus. If the mother continues to drink,
the eyes, legs and arms of the fetus can be adversely affected.
Continuous exposure further through the sixth week can have negative
impact on ear and teeth development. palate and external genitalia can
be affected if the mother persists drinking. During the twelfth week,
frequent alcohol exposure can negatively impact the brain development
which affects cognitive, learning and behavioral skills before birth.
Consumption of excessive alcohol can lead to Fetal Alcohol Syndrome
which can produce irreversible lifetime changes in physical, mental and
neurobehavioral development of the fetus. Alcohol during pregnancy not only affects the developing fetus, but it also has adverse health outcomes on the mother as well.
It can harm the fertility of women who are planning for pregnancy.
Adverse effects of alcohol can lead to malnutrition, seizures, vomiting
and dehydration. The mother can suffer from anxiety and depression which
can result in child abuse/neglect. It has also been observed that when
the pregnant mother withdraws from alcohol, its effects are visible on
the infant as well. The baby remains in an irritated mood, cries
frequently, doesn't sleep properly, has weakening of sucking ability and
increased hunger.
Alcohol consumption during pregnancy may increase the risk that the child will develop acute myeloid leukemia at a young age.
In the past, alcohol was used as a common tocolytic agent.
Tocolytic agents are drugs that are used to prevent preterm labor (born
at less than 37 weeks gestation) by suppressing uterine contraction.
However, alcohol is no longer used in current practice due to safety
concerns for the mother and her baby. A Cochrane Systematic Review has
also shown that ethanol is no better than placebo (sugar water) to
suppress preterm birth and neonatal mortality. Not only is ethanol worse
than other beta-mimetic drugs (type of tocolytic agents) at postponing
birth, it also leads to a higher rate of low birthweight babies, babies
with breathing problems at birth and neonatal death.
Signs and symptoms
When
an infant is born and appears to be healthy, they may still have
non-visible disorders and organ defects due to exposure to alcohol
during gestation. Social problems in children have been found to be associated with their mothers' alcohol use during pregnancy. Alcohol is a cause of microcephaly.
Alcohol use during pregnancy does not effect the ability to breastfeed
the infant – in addition, an infant may breastfeed even if their mother
continues to consume alcohol after giving birth. An infant born to a
mother with an alcohol dependency may go through alcohol withdrawal
after the birth.
One of the major effects of alcohol consumption during pregnancy
is Fetal Alcohol Spectrum Disorders (FASDs), of which Fetal Alcohol
Syndrome (FAS) is the most severe form. It is shown that small amounts
of alcohol consumed during pregnancy does not show any health related
issues in the face, but behavioral issues can be seen. There is a wide range of symptoms seen in persons suffering from FASDs which include:
Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum)
Small head size
Shorter-than-average height
Low birth weight
Poor coordination
Hyperactive behavior
Difficulty with attention
Poor memory
Difficulty in school (especially with math)
Learning disabilities
Speech and language delays
Intellectual disability or low IQ
Poor reasoning and judgment skills
Sleep and sucking problems as a baby
Vision or hearing problems
Problems with the heart, kidneys or bones.
There are five types of FASDs depending on the symptoms:
(1) Fetal Alcohol Syndrome;
(2) Alcohol-Related Neurodevelopmental Disorder;
(3) Alcohol-Related Birth Defects;
(4) Static Encephalopathy;
(5) Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure.
There are three approaches to treatment of FAS:
(1) At Home – A stable and loving home, along with a regular
routine, simple rules to follow and where rewards are given for positive
behavior, is a good environment for children with FAS.
(2) Medications – Medications are used to specifically treat
symptoms of FASDs and not FAS entirely. Some of the medications used are
antidepressants, stimulants, neuroleptics and anti-anxiety drugs.
(3) Counseling – Children with FAS benefit from behavioral and
functional training, social skill training and tutoring. Support groups
and talk therapy not only help the children suffering from FAS, but also
help the parents and siblings of these children.
Treatment
A
woman may elect to discontinue alcohol once she discovers that she is
pregnant. However, women can experience serious symptoms that accompany
alcohol withdrawal during pregnancy. According to the World Health
Organization, these symptoms can be treated during pregnancy with brief
use of benzodiazepinetranquilizers.
Medications
Currently, the FDA has approved three medications—naltrexone, acamprosate, and disulfiram—for the treatment of alcohol use disorder (AUD). However, there is insufficient data regarding the safety of these medications for pregnant women.
Naltrexone is a nonselective opioid antagonist that is used to treat AUD and opioid use disorder. The long-term effects of naltrexone on the fetus are currently unknown.
Animal studies show that naltrexone administered during pregnancy
increases the incidence of early fetal loss; however, there are
insufficient data available to identify the extent to which this is a
risk in pregnant women.
Acamprosate functions as both an antagonist of NMDA and glutamate and an agonist at GABAA
receptors, although its molecular mechanism is not completely
understood. Acamprosate has been shown to be effective at preventing
alcohol relapse during abstinence. Animal data, however, suggests that acamprosate can have possible teratogenic effects on fetuses.
Disulfiram prevents relapse by blocking the metabolism of acetaldehyde after consumption of alcohol which leads to headache, nausea, and vomiting.
Some evidence suggests that disulfiram use during the first trimester
is associated with an increased risk of congenital malformations such as
reduction defects and cleft palate. Additionally, the effects of disulfiram can involve hypertension which can be harmful to both the pregnant woman and the fetus.
American Psychiatric Association
guidelines recommend that medications not be used to treat alcohol use
disorder in pregnant women except in cases of acute alcohol withdrawals
or other co-existing conditions.
Instead, behavioral interventions are usually preferred as treatments
for pregnant women with AUD. Medications should only be used for
pregnant women after carefully considering potential risks and harms of
the medications versus the benefits of alcohol cessation.
Epidemiology
Alcohol consumption during pregnancy is relatively common, and its prevalence has been on the rise.
An estimated 7.6% of pregnant women use alcohol, while 1.4% of pregnant
women report binge drinking during their pregnancy. The highest
prevalence estimates of reported alcohol use during pregnancy were among
women who are aged 35–44 years (14.3%), white (8.3%), college graduates
(10.0%), or employed (9.6%).
Furthermore, alcohol-related congenital abnormalities occur at an
incidence of roughly one out of 67 women who drink alcohol during
pregnancy. The use of alcohol during pregnancy occurs at different rates
across the world, potentially due to various cultural differences and
legislation. The five countries with the highest prevalence of alcohol
use during pregnancy are Ireland (60%), Belarus (47%), Denmark (46%),
the UK (41%), and the Russian Federation (37%).
One of the biggest challenges in uncovering the true prevalence
of FAS and the associated disorders is understanding how to recognize
the syndrome, which largely depends on the age and physical features of
the individual being diagnosed.
Using medical and other records, CDC studies have identified 0.2 to
1.5 infants with FAS for every 1,000 live births in certain areas of the
United States. A more recent CDC study analyzed medical and other records and found FAS in 0.3 out of 1,000 children from 7 to 9 years of age.
Public health recommendations
Starting in 1981, the Surgeon General of the United States started releasing a warning asking pregnant women to abstain from alcohol for the remainder of gestation. The American Academy of Pediatrics
issued a set of recommendations in 2015: "During pregnancy no amount of
alcohol intake should be considered safe; there is no safe trimester to
drink alcohol; all forms of alcohol, such as beer, wine, and liquor,
pose similar risk; and binge drinking poses dose-related risk to the
developing fetus." The World Health Organization
recommends that alcohol should be avoided entirely during pregnancy,
given the relatively unknown effects of even small amounts of alcohol
during pregnancy. The United Kingdom's National Institute for Health and Clinical Excellence
recommends "that if you're pregnant or planning to become pregnant, the
safest approach is not to drink alcohol at all to keep risks to your
baby to a minimum."
There has been some controversy surrounding the zero-tolerance
approach taken by many countries toward alcohol consumption during
pregnancy. A 2000 article wrote that the concern about the risk of FAS
may be inflated beyond the level warranted by existing evidence of its
prevalence and impact and argued that equating a low level of drinking
with unavoidable harm to the fetus may have negative social, legal and
health impacts.
In capitalism, the sharing economy
is a socio-economic system built around the sharing of resources. It
often involves a way of purchasing goods and services that differs from
the traditional business model
of companies hiring employees to produce products to sell to consumers.
It includes the shared creation, production, distribution, trade and
consumption of goods and services by different people and organisations.
These systems take a variety of forms, often leveraging information technology
(particularly digital platforms) to empower individuals, corporations,
non-profits and government with information that enables distribution,
sharing and reuse of excess capacity in goods and services.
There are two main types of sharing economy initiatives:
Non-profit, usually based on the concept of book-lending
libraries, in which goods and services are provided for free (or
sometimes for a modest subscription).
Commercial, in which a company provides a service to customers for profit.
Origins
The term "sharing economy" began to appear around the time of the Great Recession, enabling social technologies, and an increasing sense of urgency around global population growth and resource depletion. Lawrence Lessig was possibly first to use the term in 2008, though others claim the origin of the term is unknown. Dariusz Jemielniak and Aleksandra Przegalinska credit Marcus Felson and Joe L. Spaeth's academic article "Community Structure and Collaborative Consumption" published in 1978 with coining the term economy of sharing.
Definition and related concepts
There is a conceptual and semantic confusion caused by the many facets of Internet-based sharing leading to discussions regarding the boundaries and the scope of the sharing economy and regarding the definition of the sharing economy.Arun Sundararajan noted in 2016 that he is "unaware of any consensus on a definition of the sharing economy". As of 2015, according to a Pew Research Center survey, only 27% of Americans had heard of the term "sharing economy".
Survey respondents who had heard of the term had divergent views on
what it meant, with many thinking it concerned "sharing" in the
traditional sense of the term.
The term "sharing economy" is often used in an ambiguous way and can imply different characteristics. For example, the sharing economy is sometimes understood exclusively as a peer-to-peer phenomenon while at times, it has been framed as a business-to-customer phenomenon.
Additionally, the sharing economy can be understood to encompass
transactions with a permanent transfer of ownership of a resource, such
as a sale, while other times, transactions with a transfer of ownership are considered beyond the boundaries of the sharing economy.
One definition of the sharing economy, developed to integrate existing
understandings and definitions, based on a systematic review is:
"the
sharing economy is an IT-facilitated peer-to-peer model for commercial
or non-commercial sharing of underutilized goods and service capacity
through an intermediary without transfer of ownership."
The
phenomenon has been defined from a legal perspective as "a for-profit,
triangular legal structure where two parties (Providers and Users) enter
into binding contracts for the provision of goods (partial transfer of
the property bundle of rights) or services (ad hoc or casual services)
in exchange for monetary payment through an online platform operated by a
third party (Platform Operator) with an active role in the definition
and development of the legal conditions upon which the goods and
services are provided."
Under this definition, the "Sharing Economy" is a triangular legal
structure with three different legal actors: "1) a Platform Operator
which using technology provides aggregation and interactivity to create a
legal environment by setting the terms and conditions for all the
actors; (2) a User who consumes the good or service on the terms and
conditions set by the Platform Operator; and (3) a Provider who provides
a good or service also abiding by the Platform Operator’s terms and
conditions."
While the term sharing economy is the term most often used, the
sharing economy is also referred to as the access economy, crowd-based
capitalism, collaborative economy, community-based economy, gig economy, peer economy, peer-to-peer (P2P) economy, platform economy, renting economy and on-demand economy, through at times some of those terms have been defined as separate if related topics.
The notion of "sharing economy" has often been considered an oxymoron, and a misnomer for actual commercial exchanges. Arnould and Rose proposed to replace the misleading term "sharing" with mutuality. In an article in Harvard Business Review,
authors Giana M. Eckhardt and Fleura Bardhi argue that "sharing
economy" is a misnomer, and that the correct term for this activity is
access economy. The authors say, "When 'sharing' is market-mediated—when
a company is an intermediary between consumers who don't know each
other—it is no longer sharing at all. Rather, consumers are paying to
access someone else's goods or services." The article states that companies (such as Uber)
that understand this, and whose marketing highlights the financial
benefits to participants, are successful, while companies (such as Lyft) whose marketing highlights the social benefits of the service are less successful. According to George Ritzer, this trend towards increased consumer input in commercial exchanges refers to the notion of prosumption, which, as such, is not new.
Jemielniak and Przegalinska note that the term sharing economy is often
used to discuss aspects of the society that do not predominantly relate
to the economy, and propose a broader term collaborative society for such phenomena.
The term "platform capitalism"
has been proposed by some scholars as more correct than "sharing
economy" in discussion of activities of for-profit companies like Uber
and Airbnb in the economy sector. Companies that try to focus on fairness and sharing, instead of just profit motive, are much less common, and have been contrastingly described as platform cooperatives (or cooperativist platforms vs capitalist platforms). In turn, projects like Wikipedia, which rely on unpaid labor of volunteers, can be classified as commons-based peer-production initiatives. A related dimension is concerned with whether users are focused on non-profit sharing or maximizing their own profit.
Sharing is a model that is adapting to the abundance of resource,
whereas for-profit platform capitalism is a model that persists in areas
where there is still a scarcity of resources.
Yochai Benkler, one of the earliest proponents of open source software, who studied the tragedy of the commons,
which refers to the idea that when we all act solely in our
self-interest, we deplete the shared resources we need for our own
quality of life, posited that network technology could mitigate this
issue through what he called 'commons-based peer production', a concept first articulated in 2002. Benkler then extended that analysis to "shareable goods" in Sharing Nicely: On Shareable Goods and the emergence of sharing as a modality of economic production, written in 2004.
Actors of the sharing economy
There
are a wide range of actors who participate in the sharing economy. This
includes individual users, for-profit enterprises, social enterprise or
cooperatives, digital platform companies, local communities, non-profit
enterprises and the public sector or the government.
Individual users are the actors engaged in sharing goods and resources
through "peer-to-peer (P2P) or business-to-peer (B2P) transactions".
The for-profit enterprises are those actors who are profit-seekers who
buy, sell, lend, rent or trade with the use of digital platforms as
means to collaborate with other actors. The social enterprise or
referred to as cooperatives are mainly "motivated by social or
ecological reasons" and seek to empower actors as means of genuine
sharing. Digital platforms are technology firms that facilitate the
relationship between transacting parties and make profits by charging
commissions.
The local communities are the players at the local level with varied
structures and sharing models where most activities are non-monetized
and often carried out to further develop the community. The non-profit
enterprises have a purpose of "advancing a mission or purpose" for a
greater cause and this is their primary motivation which is genuine
sharing of resources. In addition, the public sector or the government
can participate in the sharing economy by "using public infrastructures
to support or forge partnerships with other actors and to promote
innovative forms of sharing".
Commercial dimension
Lizzie Richardson noted that sharing economy "constitutes an apparent paradox, framed as both part of the capitalist economy and as an alternative".
A distinction can be made between free sharing, such as genuine
sharing, and for-profit sharing, often associated with companies such as
Uber, Airbnb, and Taskrabbit.
Commercial co-options of the 'sharing economy' encompass a wide range
of structures including mostly for-profit, and, to a lesser extent,
co-operative structures.
The sharing economy provides expanded access to products, services and
talent beyond one-to-one or singular ownership, which is sometimes
referred to as "disownership". Individuals actively participate as users, providers, lenders or borrowers in varied and evolving peer-to-peer exchange schemes.
The usage of the term sharing by for-profit companies has been
described as "abuse" and "misuse" of the term, or more precisely, its commodification. In commercial applications, the sharing economy can be considered a marketing strategy more than an actual 'sharing economy' ethos; for example, the company Airbnb
has sometimes been described as a platform for individuals to 'share'
extra space in their homes, but in reality the space is rented, not
shared. Airbnb listings additionally are often owned by property management corporations. This has led to a number of legal challenges, with some jurisdiction ruling, for example, that ride sharing
through for-profit services like Uber de facto makes the drivers
indistinguishable from regular employees of ride sharing companies. The escrow-like
model practiced by several of the largest sharing economy platforms,
which facilitate and handle contracting and payments on behalf of their
subscribers, further underlines an emphasis on access and transaction
rather than on sharing.
Sharing of resources has been known in business-to-business (B2B) like heavy machinery in agriculture and forestry as well as in business-to-consumer (B2C) like self-service laundry. But three major drivers enable consumer-to-consumer
(C2C) sharing of resources for a broad variety of new goods and
services as well as new industries. First, customer behavior for many
goods and services changes from ownership to sharing. Second, online
social networks and electronic markets more easily link consumers. And
third, mobile devices and electronic services make the use of shared
goods and services more convenient.
Importance of trust
In
many cases, the sharing economy relies on the will of the users to
share, but in order to make an exchange, users have to overcome stranger danger.
Access economy organizations say they are committed to building and
validating trusted relationships between members of their community,
including producers, suppliers, customers or participants.
Beyond trusting others, the users of a sharing economy platform also
have to trust the platform itself as well as the product at hand.
Size and growth
United States
According to a report by the United States Department of Commerce
in June 2016, quantitative research on the size and growth of the
sharing economy remains sparse. Growth estimates can be challenging to
evaluate due to different and sometimes unspecified definitions about
what sort of activity counts as sharing economy transactions. The report
noted a 2014 study by PricewaterhouseCoopers,
which looked at five components of the sharing economy: travel, car
sharing, finance, staffing and streaming. It found that global spending
in these sectors totaled about $15 billion in 2014, which was only about
5% of the total spending in those areas. The report also forecasted a
possible increase of "sharing economy" spending in these areas to $335
billion by 2025, which would be about 50% of the total spending in these
five areas. A 2015 PricewaterhouseCoopers study found that nearly one-fifth of American consumers partake in some type of sharing economy activity. A 2017 report by Diana Farrell and Fiona Greig suggested that at least in the US, sharing economy growth may have peaked.
Europe
A February 2018 study ordered by the European Commission and the Directorate-General for Internal Market, Industry, Entrepreneurship and SMEs
indicated the level of collaborative economy development between the
EU-28 countries across the transport, accommodation, finance and online
skills sectors. The size of the collaborative economy relative to the
total EU economy was estimated to be €26.5 billion in 2016. Some experts predict that shared economy could add between €160 to €572 billion to the EU economy in the upcoming years.
China
In China,
the sharing economy doubled in 2016, reaching 3.45 trillion yuan ($500
billion) in transaction volume, and was expected to grow by 40% per year
on average over the next few years, according to the country's State
Information Center. In 2017, an estimated 700 million people used sharing economy platforms.
Russia
According
to TIARCENTER and the Russian Association of Electronic Communications,
eight key verticals of Russia's sharing economy (C2C sales, odd jobs,
car sharing, carpooling, accommodation rentals, shared offices,
crowdfunding, and goods sharing) grew 30% to 511 billion rubles ($7.8
billion) in 2018.
Economic effects
The impacts of the access economy in terms of costs, wages and employment are not easily measured and appear to be growing.
Various estimates indicate that 30-40% of the U.S. workforce is
self-employed, part-time, temporary or freelancers. However, the exact
percentage of those performing short-term tasks or projects found via
technology platforms was not effectively measured as of 2015 by
government sources.
In the U.S., one private industry survey placed the number of
"full-time independent workers" at 17.8 million in 2015, roughly the
same as 2014. Another survey estimated the number of workers who do at
least some freelance work at 53.7 million in 2015, roughly 34% of the
workforce and up slightly from 2014.
Economists Lawrence F. Katz and Alan B. Krueger
wrote in March 2016 that there is a trend towards more workers in
alternative (part-time or contract) work arrangements rather than
full-time; the percentage of workers in such arrangements rose from
10.1% in 2005 to 15.8% in late 2015.
Katz and Krueger defined alternative work arrangements as "temporary
help agency workers, on-call workers, contract company workers, and
independent contractors or free-lancers".
They also estimated that approximately 0.5% of all workers identify
customers through an online intermediary; this was consistent with two
others studies that estimated the amount at 0.4% and 0.6%.
At the individual transaction level, the removal of a higher
overhead business intermediary (say a taxi company) with a lower cost
technology platform helps reduce the cost of the transaction for the
customer while also providing an opportunity for additional suppliers to
compete for the business, further reducing costs.
Consumers can then spend more on other goods and services, stimulating
demand and production in other parts of the economy. Classical economics
argues that innovation that lowers the cost of goods and services
represents a net economic benefit overall. However, like many new
technologies and business innovations, this trend is disruptive to
existing business models and presents challenges for governments and
regulators.
For example, should the companies providing the technology
platform be liable for the actions of the suppliers in their network?
Should persons in their network be treated as employees, receiving
benefits such as healthcare and retirement plans? If consumers tend to
be higher income persons while the suppliers are lower-income persons,
will the lower cost of the services (and therefore lower compensation of
the suppliers) worsen income inequality? These are among the many
questions the on-demand economy presents.
Cost management and budgeting by providers
Using a personal car to transport passengers or deliveries requires payment, or sufferance, of costs
for fees deducted by the dispatching company, fuel, wear and tear,
depreciation, interest, taxes, as well as adequate insurance. The driver
is typically not paid for driving to an area where fares might be found
in the volume necessary for high earnings, or driving to the location
of a pickup or returning from a drop-off point. Mobile apps have been written that help a driver be aware of and manage such costs has been introduced.
Effects on infrastructure
Uber,
Airbnb, and other companies have had drastic effects on infrastructures
such as road congestion and housing. Major cities such as San Francisco
and New York City have arguably become more congested due to their use.
According to transportation analyst Charles Komanoff, "Uber-caused
congestion has reduced traffic speeds in downtown Manhattan by around 8
percent".
Effect on the elderly
The
percentage of seniors in the work force has increased from 20.7% in
2009 to 23.1% in 2015, an increase in part attributed to the rise of the
access economy.
Benefits
Suggested benefits of the sharing economy include:
Local delivery
An
example of grocery delivery in sharing economy is Instakart. It has the
same business model as that of sharing economy based companies like
Uber, Airbnb, or CanYa. Instacart
uses resources that are readily available, and the shoppers shop at
existing grocery shops. The contract workers use their personal vehicles
to deliver groceries to customers. Instacart manages to keep its cost
low as it does not require any infrastructure to store goods. In
addition to having contract workers, Instacart allows signing up to be a
"personal shopper" for Instacart through its official web page.
Transparent and open data increases innovation
A common premise is that when information about goods is shared (typically via an online marketplace), the value of those goods may increase for the business, for individuals, for the community and for society in general.
Many state, local and federal governments are engaged in open data initiatives and projects such as data.gov.
The theory of open or "transparent" access to information enables
greater innovation, and makes for more efficient use of products and
services, and thus supporting resilient communities.
Unused value is wasted value
Unused value refers to the time over which products, services, and talents lay idle. This idle time is wasted value that business models
and organizations that are based on sharing can potentially utilize.
The classic example is that the average car is unused 95% of the time.
This wasted value can be a significant resource, and hence an
opportunity, for sharing economy car solutions. There is also
significant unused value in "wasted time", as articulated by Clay Shirky in his analysis of the power of crowds connected by information technology.
Many people have unused capacity in the course of their day. With
social media and information technology, such people can donate small
slivers of time to take care of simple tasks that others need doing.
Examples of these crowdsourcing solutions include the for-profit Amazon Mechanical Turk and the non-profit Ushahidi.
Other benefits
Encompassing
many of the listed benefits of the sharing economy is the idea of the
freelance worker. Through monetizing unused assets, such as renting out a
spare guest room on Airbnb, or providing personal services to others,
such as becoming a driver with Uber, people are in effect becoming
freelance workers. Freelance work entails better opportunities for
employment, as well as more flexibility for workers, as people have the
ability to pick and choose the time and place of their work. As
freelance workers, people can plan around their existing schedules and
maintain multiple jobs if needed. Evidence of the appeal to this type of
work can be seen from a survey conducted by the Freelancers Union, which shows that around 34% of the U.S. population is involved in freelance work.
According to an article by Margarita Hakobyan, freelance work can
also be beneficial for small businesses. During their early
developmental stages, many small companies can't afford or aren't in
need of full-time departments, but rather require specialized work for a
certain project or for a short period of time. With freelance workers
offering their services in the sharing economy, firms are able to save
money on long-term labor costs and increase marginal revenue from their
operations.
Christopher Koopman, an author of a study by George Mason University
economists, said the sharing economy "allows people to take idle
capital and turn them into revenue sources". He has stated, "People are
taking spare bedroom[s], cars, tools they are not using and becoming
their own entrepreneurs." Arun Sundararajan,
a New York University economist who studies the sharing economy, told a
congressional hearing that "this transition will have a positive impact
on economic growth and welfare, by stimulating new consumption, by
raising productivity, and by catalyzing individual innovation and
entrepreneurship".
A study in Intereconomics / The Review of European Economic Policy
noted that the sharing economy has the potential to bring many benefits
for the economy, while noting that this presupposes that the success of
sharing economy services reflects their business models rather than
'regulatory arbitrage' from avoiding the regulation that affects
traditional businesses.
An independent data study conducted by Busbud in 2016 compared the average price of hotel rooms with the average price of Airbnb
listings in thirteen major cities in the United States. The research
concluded that in nine of the thirteen cities, Airbnb rates were lower
than hotel rates by an average price of $34.56.
A further study conducted by Busbud compared the average hotel rate
with the average Airbnb rate in eight major European cities. The
research concluded that the Airbnb rates were lower than the hotel rates
in six of the eight cities by a factor of $72.
Data from a separate study shows that with Airbnb's entry into the
market in Austin, Texas hotels were required to lower prices by 6
percent to keep up with Airbnb's lower prices.
Additional benefits include:
Reducing negative environmental impacts through decreasing the
amount of goods needed to be produced, cutting down on industry
pollution (such as reducing the carbon footprint and overall consumption of resources)
Strengthening communities
Lowering consumer costs by borrowing and recycling items
Providing people with access to goods who can't afford buying them or have no interest in long-term usage
Increased quality of service through rating systems provided by companies involved in the sharing economy
Increased flexibility of work hours and wages for independent contractors of the sharing economy
Increased quality of service provided by incumbent firms that work to keep up with sharing firms like Uber and Lyft
Flexible and convenient work hours: The sharing economy allows
workers to set their own hours of work. An Uber driver explains, "the
flexibility extends far beyond the hours you choose to work on any given
week. Since you don’t have to make any sort of commitment, you can
easily take time off for the big moments in your life as well, such as
vacations, a wedding, the birth of a child, and more."
Workers are able to accept or reject additional work based on their
needs while using the commodities they already possess to make money.
Low barriers to entry: Depending on their schedules and resources,
workers can provide services in more than one area with different
companies. This allows workers to relocate and continue earning income.
Also, by working for such companies, the transaction costs associated
with occupational licenses are significantly lowered. For example, in
New York City, taxi drivers must have a special driver's license and
undergo training and background checks, while Uber contractors can offer "their services for little more than a background check".
Maximum benefit for sellers and buyers: Enables users to improve
living standards by eliminating the emotional, physical, and social
burdens of ownership. Without the need to maintain a large inventory,
deadweight loss is reduced, prices are kept low, all while remaining
competitive in the markets.
Environmental benefit: Access economies allow the reuse and
repurpose of already existing commodities. Under this business model,
private owners share the assets they already possess when not in use.
Breaking of monopolies: In Zimbabwe, Airbnb, along with other businesses of this type, has led to a rise in consumer benefits stemming from good prices and quality. This model also allows for more opportunities for those that are self-employed.
Several academics demonstrated that in 2015, Uber generated $6.8 billion of consumer welfare in the United States.
New jobs are created, and products bought, as people acquire items
such as cars or apartments to use in the sharing economy activities.
Criticism
Oxford
Internet Institute, Economic Geographer, Graham has argued that key
parts of the sharing economy impose a new balance of power onto workers.
By bringing together workers in low- and high-income countries, gig
economy platforms that are not geographically-confined can bring about a
'race to the bottom' for workers.
Relationship to job loss
New York Magazine
wrote that the sharing economy has succeeded in large part because the
real economy has been struggling. Specifically, in the magazine's view,
the sharing economy succeeds because of a depressed labor market, in
which "lots of people are trying to fill holes in their income by
monetizing their stuff and their labor in creative ways", and in many
cases, people join the sharing economy because they've recently lost a
full-time job, including a few cases where the pricing structure of the
sharing economy may have made their old jobs less profitable (e.g.
full-time taxi drivers who may have switched to Lyft or Uber).
The magazine writes that "In almost every case, what compels people to
open up their homes and cars to complete strangers is money, not
trust.... Tools that help people trust in the kindness of strangers
might be pushing hesitant sharing-economy participants over the
threshold to adoption. But what's getting them to the threshold in the
first place is a damaged economy and harmful public policy that has
forced millions of people to look to odd jobs for sustenance."
Uber's "audacious plan to replace human drivers" may increase job loss as even freelance driving will be replaced by automation.
However, in a report published in January 2017, Carl Benedikt Frey
found that while the introduction of Uber had not led to jobs being
lost, but had caused a reduction in the incomes of incumbent taxi
drivers of almost 10%. Frey found that the "sharing economy", and Uber,
in particular, has had substantial negative impacts on workers wages.
Some people believe the Great Recession led to the expansion of the sharing economy because job losses enhanced the desire for temporary work,
which is prevalent in the sharing economy. However, there are
disadvantages to the worker; when companies use contract-based
employment, the "advantage for a business of using such non-regular
workers is obvious: It can lower labor costs dramatically, often by 30
percent, since it is not responsible for health benefits, social
security, unemployment or injured workers' compensation, paid sick or
vacation leave and more. Contract workers, who are barred from forming
unions and have no grievance procedure, can be dismissed without
notice".
Treatment of workers as independent contractors and not employees
There is debate over the status of the workers within the sharing economy; whether they should be treated as independent contractors or employees
of the companies. This issue seems to be most relevant among sharing
economy companies such as Uber. The reason this has become such a major
issue is that the two types of workers are treated very differently.
Contract workers are not guaranteed any benefits and pay can be below
average. However, if they are employees, they are granted access to
benefits and pay is generally higher. This has been described as
"shifting liabilities and responsibilities" to the workers, while
denying them the traditional job security. It has been argued that this trend is de facto "obliterating the achievements of unions thus far in their struggle to secure basic mutual obligations in worker-employer relations".
In Uberland: How the Algorithms are Rewriting the Rules of Work, technology ethnographer
Alex Rosenblat argues that Uber's reluctance to classify its drivers as
"employees" strips them of their agency as the company's
revenue-generating workforce, resulting in lower compensation and, in
some cases, risking their safety. In particular, Rosenblat critiques Uber's ratings system, which she argues elevates passengers to the role of "middle managers" without offering drivers the chance to contest poor ratings.
Rosenblat notes that poor ratings, or any other number of unspecified
breaches of conduct, can result in an Uber driver's "deactivation", an
outcome Rosenblat likens to being fired without notice or stated cause.
Prosecutors have used Uber's opaque firing policy as evidence of
illegal worker misclassification; Shannon Liss-Riordan, an attorney
leading a class action lawsuit against the company, claims that "the
ability to fire at will is an important factor in showing a company's
workers are employees, not independent contractors."
The California Public Utilities Commission
filed a case, later settled out of court, that "addresses the same
underlying issue seen in the contract worker controversy—whether the new
ways of operating in the sharing economy model should be subject to the
same regulations governing traditional businesses".
Like Uber, Instakart faced similar lawsuits. In 2015, a lawsuit was
filed against Instakart alleging the company misclassified a person who
buys and delivers groceries as an independent contractor.
Instakart had to eventually make all such people as part-time employees
and had to accord benefits such as health insurance to those
qualifying. This led to Instakart having thousands of employees
overnight from zero.
A 2015 article by economists at George Mason University argued
that many of the regulations circumvented by sharing economy businesses
are exclusive privileges lobbied for by interest groups. Workers and entrepreneurs not connected to the interest groups engaging in this rent-seeking
behavior are thus restricted from entry into the market. For example,
taxi unions lobbying a city government to restrict the number of cabs
allowed on the road prevents larger numbers of drivers from entering the
marketplace.
The same research finds that while access economy workers do lack the protections that exist in the traditional economy, many of them cannot actually find work in the traditional economy.
In this sense, they are taking advantage of opportunities that the
traditional regulatory framework has not been able to provide for them.
As the sharing economy grows, governments at all levels are reevaluating
how to adjust their regulatory schemes to accommodate these workers.
Benefits not accrued evenly
Andrew Leonard, Evgeny Morozov,
criticized the for-profit sector of the sharing economy, writing that
sharing economy businesses "extract" profits from their given sector by
"successfully [making] an end run around the existing costs of doing
business" – taxes, regulations, and insurance. Similarly, In the context
of online freelancing marketplaces, there have been worries that the
sharing economy could result in a 'race to the bottom' in terms of wages
and benefits: as millions of new workers from low-income countries come
online.
Susie Cagle
wrote that the benefits big sharing economy players might be making for
themselves are "not exactly" trickling down, and that the sharing
economy "doesn't build trust" because where it builds new connections,
it often "replicates old patterns of privileged access for some, and
denial for others".
William Alden wrote that "The so-called sharing economy is supposed to
offer a new kind of capitalism, one where regular folks, enabled by
efficient online platforms, can turn their fallow assets into cash
machines ... But the reality is that these markets also tend to attract a
class of well-heeled professional operators, who outperform the
amateurs—just like the rest of the economy".
The local economic benefit of the sharing economy is offset by
its current form, which is that huge tech companies reap a great deal of
profit in many cases. For example, Uber, which is estimated to be worth
$50B as of mid-2015, takes up to 30% commission from the gross revenue of its drivers, leaving many drivers making less than minimum wage. This is reminiscent of a peak Rentier state
"which derives all or a substantial portion of its national revenues
from the rent of indigenous resources to external clients".
Other issues
Companies such as Airbnb and Uber
do not share reputation data. Individual behavior on any one platform
doesn't transfer to other platforms. This fragmentation has some
negative consequences, such as the Airbnb squatters who had previously
deceived Kickstarter users to the tune of $40,000.
Sharing data between these platforms could have prevented the repeat
incident. Business Insider's view is that since the sharing economy is
in its infancy, this has been accepted. However, as the industry
matures, this will need to change.
Giana Eckhardt and Fleura Bardhi say that the access economy
promotes and prioritizes cheap fares and low costs rather than personal
relationships, which is tied to similar issues in crowdsourcing. For
example, consumers reap similar benefits from Zipcar as they would from a
hotel. In this example, the primary concern is the low cost. Because of
this, the "sharing economy" may not be about sharing but rather about
access. Giana Eckhardt and Fleura Bardhi say the "sharing" economy has
taught people to prioritize cheap and easy access over interpersonal
communication, and the value of going the extra mile for those
interactions has diminished.
Concentration of power can lead to unethical business practices. By using a software named 'Greyball', Uber was able to make it difficult for regulatory officials to use the application.
Another schemes allegedly implemented by Uber includes using its
application to show 'phantom' cars nearby to consumers on the app,
implying shorter pick-up times than could actually be expected. Uber
denied the allegation.
Regulations that cover traditional taxi companies but not ridesharing companies can put taxis at a competitive disadvantage.
Uber has faced criticism from taxi drivers worldwide due to the
increased competition. Uber has also been banned from several
jurisdictions due to failure to comply with licensing laws.
An umbrella sharing service named Sharing E Umbrella was started in 11 cities across China in 2017 lost almost all of the 300,000 umbrellas placed out for sharing purposes during the first few weeks.
Treatment of workers/Lack of employee benefits: Since access economy
companies rely on independent contractors, they are not offered the
same protections as that of full-time salary employees in terms of
workers comp, retirement plans, sick leave, and unemployment. This debate has caused Uber to have to remove their presence in several
locations such as Alaska. Uber stirred up a large controversy in Alaska
because if Uber drivers were considered registered taxi drivers, that
would mean they would be entitled to receiving workers' compensation
insurance. However, if they were considered independent contractors they
would not receive these same benefits. Due to all of the disputes, Uber
pulled services from Alaska.
In addition, ride-share drivers’ status continues to be ambiguous when
it comes to legal matters. On New Year's Eve in 2013, an off-duty driver
for Uber killed a pedestrian while looking for a rider. Since the
driver was considered a contractor, Uber would not compensate for the
victim's family. The contract states that the service is a matching
platform and "the company does not provide transportation services, and
... has no liability for services ... provided by third parties."
Quality discrepancies: Since access economy companies rely on
independent workers, the quality of service can differ between various
individual providers on the same platform. In 2015, Steven Hill from the
New America Foundation cited his experience signing up to become a host on Airbnb
as simple as uploading a few photos to the website "and within 15
minutes my place was 'live' like an Airbnb rental. No background check,
no verifying my ID, no confirming my personal details, no questions
asked. Not even any contact with a real human from their trust and
safety team. Nothing." However, due to the reputation
model, customers are provided with a peer-reviewed rating of the
provider and are given a choice of whether to proceed with the
transaction.
Inadequate liability guarantees: Though some companies offer
liability guarantees such as Airbnb's "Host Guarantee" that promises to
pay up to 1 million in damages, it is extremely difficult to prove
fault.
Ownership and usage: The access economy blurs the difference between
ownership and usage, which allows for the abuse or neglect of items
absent policies.
Replacement of small local companies with large international tech
companies. For example, taxi companies tend to be locally owned and
operated, while Uber is California-based. Therefore, taxi company
profits tend to stay local, while some portion of access economy profits
flows out of the local community.
In
order to reap the real benefits of a sharing economy and somehow
address some issues that revolve around it, there is a great need for
the government and policy-makers to create the “right enabling framework
based on a set of guiding principles” proposed by the World Economic
Forum. These principles are derived from the analysis of global
policymaking and consultation with experts. The following are the seven
principles for regulation in the sharing economy.
The first principle is creating space for innovation.
This entails that “governments need to provide an initially encouraging
environment while also building necessary infrastructure to allow for
the development of innovation hubs.”
The second principle is that sharing economy should be people centered.
This means that policies should be focused on “increasing the overall
welfare of the population” as well as “improving the quality of life.”
The third principle is taking a proactive approach. This
means that “new business models need to be brought into the mainstream
and governments need to make clear frameworks that minimize
uncertainty.”
The fourth principle is the assessment of the whole regulatory system
which means administrative burdens on exiting systems should be lifted
in order to give equal level of access to all actors in the network.
The fifth principle is the data-driven government. Since most
sharing economy relies on the use of digital platforms, data can be
easily collected, analyzed, and shared which can boost the urban
environment through public-private partnerships.
The sixth principle talks about the flexible governance where
actors should consider the nature of technology which is fast evolving.
This calls for a sustained dialogue with key stakeholders, so all
interests and rights are further protected and safeguarded.
The last principle is a shared regulation where all the players should be involved in regulatory discussions as well as in the enforcement of policy.
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