I would not say that I run things the same way as you do. When I play a game of Rimworld, I want to immerse myself into the gameplay. I want to be able to make a colony and play the game the way I think that colony would run.
Borg? Sure-- just get transhumanists.
Drug runners? You just need good growers and social people.
Tribal nomads? Why not?
I don't think that real-world morals should apply while in a game. Yes, I think the borg are an atrocious species. Yes, I think that drug runners are abhorrent. I personally wouldn't live as a tribal nomad. But I think that these options were put into the game so that people could experience them.
Also, being organ traders probably started with TheSpiffingBrit on Youtube. It is fairly lucrative...