The Secretary of the Treasury was directed, among other provisions of the act, to create "medals of honor", to be distinguished as life-saving medals of the first and second class, and bestow them upon any persons who endanger their own lives in saving, or endeavoring to save lives from perils of the sea, within the United States, or upon any American vessel.

If neither the Gold nor Silver Lifesaving Medal is appropriate, then a Certificate of Valor or an appropriate Coast Guard Public Service Award may be considered.

"[3] Until the mid-20th century, the Lifesaving Medal was often bestowed upon members of the military; however in recent times the decoration has become somewhat rare.

This is due primarily to the creation of a variety of additional military decorations that supplant the Lifesaving Medal.

"Military personnel serving on active duty would normally not be recommended for Gold and Silver Lifesaving Medals; however, military personnel may be recommended for a Lifesaving Medal if the act of heroism was performed while the individual was in a leave or liberty status.

[5] The US Coast Guard, while an armed force and military service at all times, normally is part of the Department of Homeland Security.