Where is the scary warning about macros within the document? I thought that macros are not executed by default, and you must trust the source for executing the macros.

I am not trying to downplay it, it's still a privilege escalation. But is triggering it via Word macros in any way special?

edit:

At my work computer, the setting is "disable all macros with notification". I suspect, but I am not sure that this is the default for a fresh Office install.

With this setting running macros on a random Word document is not much different than running a random .exe file. Of course, privilege escalation is equally serious in both cases.