Established in 1874, the Silver Lifesaving Medal represents the almost singular mission of one of the modern-day Coast Guard’s two progenitors: the United States Life-Saving Service.
The service began in 1848 as a Federally funded but unnamed system of life-saving stations along the Northeastern coast of the United States, specifically in New York, New Jersey, and Massachusetts. Administration of the stations fell to the U.S. Revenue Marine Division, an agency within the Treasury Department, but even so the service was not officially recognized and the stations themselves were operated by local volunteers.
That situation began to change when an attorney named Sumner Kimball was named Chief of the Revenue Marine Division in 1871. Coaxing Congress into appropriating $200,000 to expand and improve the system of life-saving stations, and by 1874 they reached from Maine to the Outer Banks in North Carolina. This increased focus on the services provided by the stations, which included rescuing shipwrecked sailors, led the Department of the Treasury to establish a Lifesaving Medal to be issued in two classes; these eventually became the Gold and Silver Lifesavings Medals the Commandant of the Coast Guard awards today. (Interestingly, the naming of the medals came four years before the system of stations was officially titled the United States Live-Saving Service.)
Both the Gold and Silver Lifesaving Medals are awarded for individuals who rescue or make an effort to rescue another person from drowning or shipwreck, but the rescue efforts must take in U.S. waters (or waters under the purview of the U.S.) and involve at least one U.S. citizen. The determining factor as to whether a person recommended for the honor receives the Gold or Silver Medal is straightforward: only those rescues who put their own lives at risk while attempting to save others qualify for the Gold version. But this doesn’t mean that everyone who saves someone from drowning (or tries to) is eligible for the Silver Lifesaving Medal. The rescue attempt must display “extraordinary effort,” so while rescuing an infant who is face-down in a plastic kiddie pool is undeniably laudable, it does not require extraordinary effort and thus is not eligible for the award.