The Wall of Flesh's sweep direction is determined by its spawn location. If a Mediumcore player dies in lava (in the Underworld, and Guide is alive) with a Guide Voodoo Doll in their inventory, then the Wall of Flesh will be summoned. Using this method, the Guide can die by any means, either from a player, an enemy or the environment, as long as he is touching lava when he dies. In the Desktop version, Console version, and Mobile version, the Wall of Flesh can also be summoned by letting the Guide be killed in the Underworld while the Guide is in contact with lava.
Dropping the doll into lava outside of Underworld or when the Guide is not alive will not spawn it, and the Voodoo Doll will be destroyed with no effect.
The Wall of Flesh is summoned immediately 75 blocks away from all visible players when a Guide Voodoo Doll is destroyed by being dropped into lava in the Underworld while the Guide is alive, killing the Guide.