The book investigates the systemic failures within the child welfare system that led to the death of an infant named David. Richard J. Gelles, formerly a proponent of family preservation, recounts the tragic case of David Edwards, who was murdered by his mother. This event prompted Gelles to advocate for prioritizing child safety over family preservation. The book details Gelles's proposed reforms, which include re-evaluating mandatory reporting, focusing resources on severe maltreatment cases, improving risk assessment, enhancing caseworker training, and separating abuse investigation from case management.

The book is regarded as a critical examination of child welfare policies, stemming from a deeply personal and tragic case. Gelles's shift from a defender of family preservation to an advocate for child removal highlights the profound impact of the David Edwards case. The work offers concrete suggestions for systemic reform, aiming to prevent future tragedies by reorienting the system's priorities and improving its operational effectiveness. It serves as a significant contribution to the discourse on child protection and social policy.