Since the 1990s, critical response to preimplantation genetic testing for monogenic disease (PGT-M) and enforced prenatal testing in Japan has raised profound moral questions, among them, “Is it better for a child with severe hereditary disease not to be born?” This question is at the root of many citizens’ resistance to Japan’s former Eugenic Protection Law. The fallout of this now-unconstitutional law included discrimination against those with certain hereditary diseases and the rise of eugenic ideas. In this chapter, we examine how the Japanese view PGT-M and discuss its societal and ethical challenges as illustrated through several case studies with patients.