In this chapter, the authors present five changes in people’s attitude and behaviour, which not only can explain the decline of trust, but which must almost inevitably lead to a decline of trust. The first four changes may be summarised under the heading ‘loss of physicians’ authority’: (1) the discrediting of ‘professionalism’, which has led to a decline of professional authority; (2) the insistence on (and difficulty of) assessing physicians’ trustworthiness and the loss of merit-based authority; (3) a questioning of physicians’ medical authority caused by the disavowal of the basic tenets of scientific medicine (often referred to as the ‘crisis of modern medicine’); (4) increasing doubts regarding the physician’s agency and directive authority caused by the perceived commodification of medicine and a reconceptualisation of physicians as dependent employees. The fifth change refers to changes of risk perception and increasing risk-averseness. Contrary to what many believe, it is not risks which have increased, but uncertainty. Yet, people perceive this increase of uncertainty as an increase of risk – a risk which an increasing number of people are no longer willing to accept.