Why is Unwind a dystopia?

The novel Unwind depicts a dystopia, which is a kind of society. The term “dystopia” is derived from “utopia,” a term coined in the sixteenth century to describe an ideal society. A dystopia is the opposite: a drastically imperfect society that, instead of supporting or nurturing its members, exercises harsh or unhealthy controls over them. Dystopias are typically led by non-democratic governments, especially dictatorships or totalitarian regimes. The members of the society are often unaware of the highly repressive measures that the government employs because there is a pervasive, efficient propaganda machine that disguises the truth. In addition, technological measures, including medical procedures, are applied to controlling the population’s thoughts and actions.
In the society that Neal Shusterman depicts, these features appear to some extent. In particular, the medical technology to harvest and transplant organs and other body parts is highly advanced. The society’s members take this for granted, in part because they are constantly fed propaganda that makes them accept the idea that children will be sacrificed for the greater good. The euphemisms for killing the teenagers make it appear as though they are not dying but serving a noble cause by helping others live. Because the people are not encouraged to think for themselves, they see no reason to challenge the status quo.

Let's first tackle the question of what a dystopian society is, and then figure out how Unwind might match up to a dystopia. Different sources have slightly different wordings for what a dystopian society is, but a solid working definition that I give my students is the following definition.

A futuristic, imagined universe in which oppressive societal control and the illusion of a perfect society are maintained through corporate, bureaucratic, technological, moral, or totalitarian control.

Now that we have a working definition, let's "unwind" it in order to see how Unwind fits or doesn't fit. The definition starts by saying that a dystopian society is a future society. That is technically correct about this story. It does take place in the future; however, it is a near future. Despite being a near future, technology does exist that doesn't exist today, and that helps sell the idea of a future society. The technology is called "neurografting," and it allows doctors to use every part of a donor for transplants into a different recipient. This is not currently possible with today's technology.
The second part of the definition introduces the concept of "societal control" through one method or another. While each of those methods are different, they likely all use propaganda of some sort. Unwind fits that characteristic of a dystopia. The book's "Bill of Life" has been used to convince people of the morality and legality of the unwinding process. The people have somehow completely bought into the idea that an aborted, unwound child isn't actually dead.

However, between the ages of thirteen and eighteen, a parent may choose to retroactively "abort" a child . . . on the condition that the child's life doesn't "technically" end.

An opening part of the book has a great quote from a child named Samson Ward that is going to be unwound. His quote shows the power of the propaganda that he has bought into.

"I was never going to amount to much anyway, but now, statistically speaking, there's a better chance that some part of me will go on to greatness somewhere in the world. I'd rather be partly great than entirely useless."

Finally, a major and standard dystopian characteristic is that the people in the society live in a dehumanized state. That isn't entirely true for Unwind. Only the teenagers are treated as less than fully human. Before the age of 13, a person can't be retroactively aborted. This is also true after a person turns age 18. Anytime between those two ages, though, the person is nothing more than a potential carrier of spare body parts.