In America after the Second Civil War, the Pro-Choice and Pro-Life armies came to an agreement: The Bill of Life states that human life may not be touched from the moment of conception until a child reaches the age of thirteen. Between the ages of thirteen and eighteen, however, a parent may choose to retroactively get rid of a child through a process called unwinding. Unwinding ensures that the child's life doesn't "technically" end by transplanting all the organs in the child's body to various recipients. Now a common and accepted practice in society, troublesome or unwanted teens are able to easily be unwound.

With breathtaking suspense, this book follows three teens who all become runaway Unwinds: Connor, a rebel whose parents have ordered his unwinding; Risa, a ward of the state who is to be unwound due to cost-cutting; and Lev, his parents' tenth child whose unwinding has been planned since birth as a religious tithing. As their paths intersect and lives hang in the balance, Shusterman examines complex moral issues that will keep readers turning the pages until the very end.