Mary Ann Glendon's book is both an exploration of key human rights issues and an assessment of the United Nations's role in defining and defending human rights. The primary theme, therefore, is the ongoing global importance of human rights. A closely related theme is the necessity for effective policies and practices to defend human rights, especially in locations where those rights are abused or rejected.

In supporting another related theme—the changing historical attitudes towards human rights—Glendon focuses on the United Nations, because the writing and publication of its 1948 Universal Declaration of Human Rights (UDHR) was a unique achievement at the time and became the benchmark document against which the success of subsequent actions were assessed.

In an effort to balance her support of human rights concepts and activism, Glendon also presents distinct political perspectives on the role of states in these matters, as well as provides relativist perspectives that often associate "universal" human rights with ethnocentrism and even imperialism.

The story of the creation of a human rights declaration is intertwined both with the creation of the United Nations itself—an organization in its infancy when then declaration was drawn up—and with the active participation of one unique woman: former First Lady Eleanor Roosevelt, one of the first US delegates to the new organization. As Chair of the Commission on Human Rights, Roosevelt is widely credited with getting the UDHR passed, if not actually authoring it herself. Glendon profiles the primary author of the document, France’s René Cassin, and six other key authors.

As Glendon points out, the beginning of the Cold War illustrated the conflicting points of view that different contributors brought to the document, including the idea of absolute or universal rights—which was in contrast to the dominance of state sovereignty in defining or limiting those rights.

She further notes that the UN's endorsement of "human rights" preceded (by more than 15 years) the legal recognition of "civil rights" in the United States and points to provisions of the UN document that advanced the cause of rights in many countries.