<Tr> <Th> Next (lower) </Th> <Td> Presidential Citizens Medal </Td> </Tr> <Tr> <Td_colspan="2"> Service ribbon of the Presidential Medal of Freedom (left: Medal with Distinction) </Td> </Tr> <P> The Presidential Medal of Freedom is an award bestowed by the President of the United States and is--along with the comparable Congressional Gold Medal--the highest civilian award of the United States . It recognizes those people who have made "an especially meritorious contribution to the security or national interests of the United States, world peace, cultural or other significant public or private endeavors". The award is not limited to U.S. citizens and, while it is a civilian award, it can also be awarded to military personnel and worn on the uniform . </P> <P> It was established in 1963 by President John F. Kennedy, superseding the Medal of Freedom that was established by President Harry S. Truman in 1945 to honor civilian service during World War II . </P>

Who decides who gets the presidential medal of freedom