After my presentation at NSConference there was a discussion of default settings for the login keychain. I mentioned that I had previously recommended some keychain configuration changes including using a different password than your login password. Default behaviour is that any application can add a secure item to the keychain, and the app that did the adding is allowed to read and modify the entry without any user interaction. As Mike Lee added, all other apps will trigger a user dialogue when they try to do so - the user doesn't then need to authenticate but does have to approve the action.
That almost - but not quite - solves the issue of a trojan horse attempting to access the secure password. Sure, a trojan application can't get at it without asking the user. What about other trojan code? How about a malicious SIMBL hijack or a bundle loaded with mach_override? It should be possible to mitigate those circumstances by using custom code signing requirements, but that's not exactly well documented, and it's not really good usability for an app to just die on its arse because the developer doesn't like the other software their user has.
There's a similar, related situation - what if the app has a flawed design allowing it to retrieve a keychain item when it doesn't need it? Sounds like something which could be hard to demonstrate and harder to use, until we remember that some applications have "the internet" as their set of input data. Using a web browser as an example, but remembering that I have no reason to believe whether Safari, Camino or any other browser is designed in such a way, imagine that the user has stored an internet password. Now all that the configuration settings on the user's Mac can achieve is to stop other applications from accessing the item. If that browser is itself subject to a "cross-site credentials request" flaw, where an attacking site can trick the browser into believing that a login form (or perhaps an HTTP 401 response, though that would be harder) comes from a victim site, then that attacker will be able to retrieve the victim password from the keychain without setting off any alarms with the user.
If the user had, rather than accepting the default keychain settings, chosen to require a password to unlock the keychain, then the user would at least have the chance to inspect the state of the browser at the time the request is made. OK, it would be better to do the right thing without involving the user, but it is at least a better set of circumstances than the default.