Bioethics is as good as the people sitting on the ethical panels.
Obviously, when a person sitting on an ethical panel has a utilitarian view of life, the decisions are going to be quite different than if they have appreciation for the intrinsic value of each human life.
There are medical journals dedicated to exploring the many issues of bioethics—it is not easy to come up with ethical solutions to many situations.
I have sat on institutional review boards—groups consisting of researchers, physicians, and interested lay people—whose function is to review human research protocols and decide whether they can be ethically conducted. These discussions can be quite involved.
As far as considering every person an organ donor (with perhaps a provision for them to opt out), I am absolutely against this. I have extreme moral issues with the practice of organ transplants; I cannot justify forcing people to submit to being donors (even though they are dead at that point).
If a human being can be considered a farm animal that can be harvested for useful organs after death without consent, why not proceed to the next step of human husbandry, where people are bred and grown for the express purpose of being harvested when needed? I don't see any logical boundary that such an ethicist can draw between harvesting after death to consciously breeding people for organ harvesting.
For myself, I choose to be an organ donor because I am free to do so. I'll give freely what's mine; if I'm not my own, they'll have to take it over my dead body, so to speak.
The Fascist conception of the State is all-embracing; outside of it no human or spiritual values can exist, much less have value. Thus understood, Fascism is totalitarian, and the Fascist State -- a synthesis and a unit inclusive of all values -- interprets, develops, and potentiates the whole life of a people.
Benito Mussolini