But people have the choice of wether to live in that country or not. And citizens have the means to elect a new government to change that law. Because people that live in Spain know that the default is opt-in (or at least have the opportunity to find out), they have made a choice to either allow, or not allow organ harvesting. So, yes, removing the organs of someone who has not consented is unethical, regardless of the locale.
Spain (and many other countries) decided that they would rather be opt-out, so by default you've consented. This is actually a great example of the power of defaults to affect an outcome. Because of this out-out, the number of donations increases significantly.
I'd be more interested to know what happens to foreigners. I suspect that they aren't treated as consenting, but I don't know.
This goes to the definition of "ethical", and it's distinct from "moral", in the sense that ethics are a codified set of rules or guidelines: one does not judge something as ethical based on the result, but based on its conformity to a set of explicit or implicit expectations of conduct.
Ethics can be personal though, and there are many different forms, many of which explicitly focus on the result, and many which do not. I still think that it is very difficult to separate the concept of ethics from the notion of harm. Even where codified, the concept of avoiding harm, if only to members of your own clade for the more tribal forms, is pretty central to the formulation of pretty much all ethical systems.
Spain (and many other countries) decided that they would rather be opt-out, so by default you've consented. This is actually a great example of the power of defaults to affect an outcome. Because of this out-out, the number of donations increases significantly.
I'd be more interested to know what happens to foreigners. I suspect that they aren't treated as consenting, but I don't know.