He has to be by the rules - problem is, by the rules, he had to be ejected last night too. Stolen from the NBA rule book by way of TrueHoop:
l. A player, coach or trainer must be ejected for
...
(3) An elbow foul which makes contact above shoulder level
I believe these same type of fouls (punches and elbows to the neck/head) also are automatic suspensions. Should be open and shut - I think they suspend him, especially since this isn't an elimination game for Orlando. They lose a lot of credibility, if there's much left to lose, if they let Howard go on this.