Only a Scandinavian dystopia would unravel in a setting “furnished in a modern style and tastefully decorated in muted colors” such as “eggshell white.” And only a Scandinavian dystopia, perhaps, would see mandatory paternal leave as a slippery slope to compulsory childcare and then to compulsory parenthood and the criminalization of traditional gender roles. This is a dystopia for a shrinking country. In The Unit, all childless women over fifty and childless men over sixty are classified as “dispensable” and removed to facilities where they take part in scientific experiments and eventually donate all of their organs to “needed” individuals.

The Unit uncannily echoes its organ-donation-dystopia predecessor, Kazuo Ishiguro’s  Never Let Me Go (2005); both imagine societies of extreme utilitarianism that plunder their margins for body parts, and both raise the prospect of art for art’s sake, and love for love’s, as weapons against such thinking. The Unit’s heroine, Dorrit, has chosen not to have children and thus “spill over like rising bread dough”; at the book’s opening, Dorrit’s independence has just earned her incarceration in the Unit, a death camp puzzlingly replete with art galleries and gourmet restaurants where her individualism seems to lapse into passivity.

Through flashbacks, we learn of all Dorrit has lost—her career as a novelist, her beloved dog, the small house she owned herself, the opportunities to save herself by becoming “useful” to society. These snippets of memory are interspersed with descriptions of the eponymous unit and its dying inhabitants, descriptions so matter-of-fact they lull. The novel grips toward the end when Dorrit finds love—and with it a potential escape—and makes a startling choice.

Dorrit’s play-by-play narration can be clunky in translation, but the spare, cumulative prose effectively reveals a character whose story can barely ward off the disintegration of the self it relates. Holmqvist cleverly makes that very self unreliable; The Unit is the latest in a trend of anti-heroic dystopias such as Never Let Me Go and P.D. James’s The Children of Men. In these novels of bad futures, the trustworthy memories of protagonists such as Nineteen Eighty-Four’s Winston Smith (“Airstrip One . . . had been called England or Britain, though London, [Winston] felt fairly certain, had always been called London”) are replaced by the self-delusions of narrators who mislead the reader and themselves lose control of the stories they are telling. In these novels, rebellion must be expressed obliquely. Like Kathy, the complacent carer of Never Let Me Go, who survives her childhood friends, nursing them as they donate all their organs, Dorrit displaces her anger onto a clearer-eyed friend who calls the Unit what it is, a “luxury slaughterhouse.”

While Holmqvist builds a powerfully imaginative scenario around the concept of killing off the childless, her message on gender roles is clumsy and unconvincing. In Dorrit’s world, flirting and other “typically male” behavior has been criminalized, and retrograde domestic fantasies have to be played out in secret, making the missionary position an act of transgression. We have come a long way from the rage of Margaret Atwood’s 1985 A Handmaid’s Tale, with its neo-Biblical America in which all women are forced either to bear children or to raise them. In today’s climate of threatened reproductive rights, a critique of compulsory motherhood would be welcome, but The Unit displays the same innate conservatism that is the pitfall of Never Let Me Go—a disturbing willingness to locate tragedy not in the horror of forced organ donation and premature death, but in Kathy and Dorrit’s lost opportunities to become mothers.