© The Author(s) 2021. It is argued that editors have a moral responsibility to reject submissions that they felt publication of which may cause harm. However, Ploeg and others suggest that there may exist better alternatives to rejection. He also called for the code of publication ethics to incorporate acknowledgement of the moral responsibility for the effects of publishing, define benefits and harms of publishing, and specify a range of actions an editor may take. This letter highlights a recent such rejection ostensibly made on the basis of harm, but could easily be construed as editorial bias, and supports the call for improving the code of publication ethics to guide editors and secure consistency in decisions.