[mbreese]

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.