In my opinion it should be prescribed on a case by case basis. The reality is a lot of folks will continue to lose ground even while on Fin or can't take for life due to sides. Then there are the cases who without Fin will do well for long period of time, as I mentioned in my example. So it is not a black or white issue at all.
Some doctors will insist on patients taking Fin in every case. This approach is also questionable in my opinion. The reality is a lot of patients proceeds with HT without Fin, they may regret this sooner or later on. So in conclusion, HT without Fin should be a calculated Riks, and you should ensure you have green light from reputable Dr.