The Medal of Honor is the highest honor, given by the United States, for the highest form of valor in combat. While the medals of the invidual services have different designs, they all use the same name. Criteria for the award include that it is for action above and beyond the call of duty, under enemy fire, and for an act that could not have been ordered. Many medals are bestowed posthumously, because the person qualifying for the Medal died in the valorous act, such as Charles Loring. If a senior officer receives it, that officer was usually under direct enemy fire, such as James Doolittle in the Doolittle Raid or David Shoup at the Battle of Tarawa. There have been a very few awarded apparently for political or morale reasons, as to Douglas MacArthur; such awards have been much criticized.
Medals of comparable precedence in other countries include the British and Commonwealth Victoria Cross, and the George Cross for comparable valor in a noncombat situation. While some Soviet awards of the Hero of the Soviet Union medals were political, legitimate military Hero medals (and now Hero of the Russian Federation) are considered comparable.
Before the early 20th century, it was the only U.S. honor for combat valor, and many medals awarded were revoked or downgraded.
In what is called the "Pyramid of honor", the next, and still elite, decoration for valor in combat is the (Army) Distinguished Service Cross, the Navy Cross, or the Air Force Cross. The Distinguished Service Medal, awarded for noncombat action ranks below these decorations in precedence.
The first (posthumous) recognition, to a United States Marine went to CPL Jason Dunham, who protected his comrades by throwing himself on a grenade in 2004. The destroyer USS Jason Dunham (DDG-106) has been named in his honor.