Artificial intelligence (AI) has revolutionised medicine, particularly radiology, transforming our ability to interpret complex imaging data. While traditional methods rely on subjective visual assessments, AI excels at recognising intricate patterns and providing quantitative and automated evaluations. In this commentary, I delve into the various ethical considerations in algorithmic radiology, beyond the conventional concerns. Focusing on utilitarianism, patient understanding, virtue ethics, and social contract theory, the paper contributes to a comprehensive understanding of the ethical landscape surrounding AI technologies. The challenges in the use of algorithmic AI in radiology underscore the significance of the ethics of care, responsiveness to context, and the role of human emotion, whether pertaining to the practitioner, the patient, or both. The social contract theory guides the responsibilities of healthcare professionals, urging action to address biases in AI algorithms and ensuring equitable representation of various ethnic and racial populations. Diversity in data must be prioritised to avoid disparities in administering healthcare and uphold patient rights in the adoption of AI. In terms of virtue ethics, professionalism and responsibility are crucial for radiologists adopting AI. Also, an absence of explicit guidelines on the use of AI in healthcare poses challenges, necessitating further discourse. Finally, a utilitarian perspective on public health mandates a fair distribution of imaging technologies to address prevalent health issues in a given population. In conclusion, this paper advocates for an ethical approach to AI integration, which aligns technology with human values and wellbeing, as we shape the future of healthcare.